PURPOSE To (i) describe changes in health-related quality of life (HRQoL) pre-operatively, at discharge, and 4 weeks after discharge following open heart surgery, (ii) compare the performance of the EuroQol Questionnaire (EQ-5D 5L) and the Kansas City Cardiomyopathy Questionnaire (KCCQ) against an anchor-based approach, and to (iii) investigate the association between HRQoL and 180-day readmission. METHODS A prospective, consecutive cohort (single-center study) of 291 patients completed the EQ-5D 5L and KCCQ pre-operatively, at discharge and 4 weeks post-discharge. Changes in HRQoL over time were evaluated, and the performance of the instruments was investigated. The association between HRQoL and readmission were investigated with Cox Proportional Hazard models. RESULTS Scores of the EQ-5D Index and VAS decreased significantly from the pre-operative assessment to discharge and improved from discharge to 4 weeks after. The KCCQ scores significantly improved from baseline to 4 weeks after. Minimal clinically important improvements from before surgery to 4 weeks after were seen among 24% (EQ-5D Index), 45% (EQ-5D VAS), and 57% (KCCQ). More than one-third experienced worse HRQoL 1 month after discharge. Area under the curve (AUC) (performance of the instruments) demonstrated the following: EQ-5D Index AUC 0.622 (95% CI 0.540-0.704), VAS AUC 0.674 (95% CI 0.598-0.750), and KCCQ AUC 0.722 (95% CI 0.65-0.792). None of the HRQoL measurements were associated with 180-day readmission. CONCLUSIONS This study revealed that HRQoL measured with the EQ-5D is significantly worse at discharge compared to before surgery, but scores increases within the first month measured with the EQ-5D and the KCCQ. The EQ-5D and KCCQ have a moderate correlation with an anchor-based approach but were not associated with readmission.

中文翻译：

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开心脏瓣膜手术后会发生什么？与健康有关的生活质量的变化。

目的（i）描述心脏手术后术前，出院时和出院后4周健康相关生活质量（HRQoL）的变化，（ii）比较EuroQol问卷（EQ-5D 5L）的性能堪萨斯城心肌病问卷（KCCQ）反对基于锚的方法，并且（iii）研究HRQoL与180天再入院之间的关系。方法一项前瞻性，连续性队列研究（单中心研究）共291例患者，在出院前和出院后4周完成了EQ-5D 5L和KCCQ的手术。评估了HRQoL随时间的变化，并研究了仪器的性能。使用Cox比例危害模型研究了HRQoL与再入院之间的关联。结果从术前评估到出院，EQ-5D指数和VAS的得分显着下降，从出院到术后4周，其得分有所提高。从基线到4周后，KCCQ评分显着提高。从24％（EQ-5D指数），45％（EQ-5D VAS）和57％（KCCQ）观察到从术前到术后4周的临床意义上最小的改善。出院1个月后，超过三分之一的患者的HRQoL较差。曲线下面积（AUC）（仪器的性能）表现出以下几点：EQ-5D指数AUC 0.622（95％CI 0.540-0.704），VAS AUC 0.674（95％CI 0.598-0.750）和KCCQ AUC 0.722（95 ％CI 0.65-0.792）。没有HRQoL测量与180天再入院相关。结论：这项研究表明，与手术前相比，用EQ-5D测量的HRQoL在出院时明显更差，但是在使用EQ-5D和KCCQ测量的第一个月内，分数会提高。EQ-5D和KCCQ与基于锚的方法具有适度的相关性，但与再入院无关。