Short and Midterm Health Related Quality of Life in Patients with Acute Type B Aortic Dissection after Thoracic...

Acute type B aortic dissection (ATBD) is a severe cardiovascular event with potential impact on health related quality of life (HRQoL). Evidence on post-operative rehabilitation and exercise guidance remains limited. This study evaluated HRQoL among patients with ATBD after thoracic endovascular aortic repair (TEVAR), focusing on follow up duration, sex, and age.

This single centre, cross sectional survey study initially screened 625 patients who underwent TEVAR for ATBD between 1 January 2016 and 31 July 2023. HRQoL was assessed using the Chinese versions of the Medical Outcomes Study 36 Item Short Form Health Survey (SF-36v2). Physical Component Summary (PCS) and Mental Component Summary (MCS) scores were compared with sex specific Shanghai normative values, and factors associated with PCS and MCS were analysed.

Three hundred and six patients completed interviews. PCS was lower than sex specific Shanghai normative values in both men and women, whereas MCS was not significantly lower than the corresponding normative values. In multivariable analyses, being a woman was associated with lower PCS (β = -2.77, 95% confidence interval [CI] -5.49 - -0.06; p = .045), and increasing age was associated with lower PCS (β = -0.18 per year, 95% CI -0.26 - -0.10; p < .001). For MCS, follow up duration of 13 - 24 months compared with ≤ 12 months was associated with lower scores (β = -3.34, 95% CI -5.61 - -1.08; p = .004).

Patients with TEVAR treated ATBD had lower PCS than sex specific Shanghai normative values, while MCS was not significantly lower. Increasing age and being a woman were associated with lower PCS, suggesting that physical HRQoL after TEVAR may differ across patient subgroups. These findings support incorporating patient reported outcomes and individualised assessment of physical recovery into post-TEVAR follow up.