Impact of Social Support on Patient-Reported Outcomes in Cardiothoracic Surgery: A Systematic Review

Disparities in cardiothoracic surgery recovery outcomes highlight the need to understand the impact of social determinants, such as social support, on patient-reported outcomes (PROs). This systematic review synthesizes evidence on the relationship between social support and PROs following cardiothoracic surgery.

Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched PubMed/MEDLINE, Embase, CINAHL, and Cochrane CENTRAL. Three reviewers screened studies independently, with a fourth resolving conflicts. Included studies examined adult cardiothoracic surgery patients and assessed the association between social support and at least one PRO domain: physical functioning, mental health, symptom burden, or health-related quality of life.

Thirty-one studies (N = 10,920) met the inclusion criteria. Only 26.1% of participants were women, and 10.5% were racial minorities. Most studies found that emotional, informational, tangible, and physical support were positively associated with improved PROs, including better mental health, physical recovery, and lower symptom burden. However, women received less support and reported greater anxiety, fatigue, and depression. Racial and ethnic minorities were underrepresented, and no studies directly compared outcomes across racial/ethnic subgroups.

Social support is associated with improved PROs following cardiothoracic surgery, yet key disparities persist. Women and racial minorities remain underrepresented in this literature, and their outcomes are poorly characterized. Future research should focus on inclusive study designs and targeted interventions to enhance support and improve outcomes for underserved populations.