Quality of life after open descending thoracic and thoracoabdominal aortic repair: A prospective cohort study

To longitudinally evaluate health-related quality of life (HRQoL) following open descending thoracic or thoracoabdominal aortic aneurysm repair, with validated patient-reported outcome measures.

In this prospective, single-center cohort study, patients who underwent open descending thoracic or thoracoabdominal aortic aneurysm repair between 2016 and 2023 were included. HRQoL was assessed preoperatively and at 3, 12, and 24 months postoperatively with the Short Form-12 physical component summary (PCS) and mental component summary (MCS) scores. Secondary quality-of-life scores were included as well. Additionally, complete-case analysis and the impact of baseline variables were assessed. Longitudinal changes were analyzed with linear mixed-effects models.

In total, 128 patients were included. PCS scores (95% CIs) decreased from 46.0 (44.1-48.0) preoperatively to 39.7 (37.6-41.7) at 3 months, with partial recovery to 42.2 (40.2-44.2) at 1 year and 41.0 (38.1-43.9) at 2 years (overall P < .001). MCS scores (95% CIs) decreased initially from 47.4 (44.9-49.8) to 44.3 (41.8-46.9) (3 months), with recovery to 49.2 (46.7-51.7) (1 year) and 48.4 (44.6-52.2) (2 years) (overall P = .01). Complete-case analysis showed comparable trajectories. Anxiety decreased and cognitive complaints increased but remained within normal ranges. No baseline variables were independently associated with PCS or MCS score trajectories.

Open descending thoracic and thoracoabdominal aortic aneurysm repair is associated with a sustained reduction in physical HRQoL, while mental HRQoL recovers. These findings underscore the multidimensional nature of recovery and the importance of integrating patient-reported outcomes into perioperative care.