Long-Term Health-Related Quality of Life following Acute Type A Aortic Dissection with a Focus on Male–Female Differences: A Cross Sectional Study

Author:

Meccanici Frederike1ORCID,Thijssen Carlijn G. E.12,Gökalp Arjen L.3,Bom Annemijn W.1,Geuzebroek Guillaume S. C.4ORCID,ter Woorst Joost F.5ORCID,van Kimmenade Roland R. J.12,Post Marco C.67,Takkenberg Johanna J. M.3ORCID,Roos-Hesselink Jolien W.1ORCID

Affiliation:

1. Department of Cardiology, Erasmus MC, 3015 GD Rotterdam, The Netherlands

2. Department of Cardiology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands

3. Department of Cardiothoracic Surgery, Erasmus MC, 3015 GD Rotterdam, The Netherlands

4. Department of Cardiothoracic Surgery, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands

5. Department of Cardiothoracic Surgery, Catharina Ziekenhuis Eindhoven, 5623 EJ Eindhoven, The Netherlands

6. Department of Cardiology, St. Antonius Ziekenhuis, 3435 CM Nieuwegein, The Netherlands

7. Department of Cardiology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands

Abstract

Objectives: Acute type A aortic dissection (ATAAD) is a life-threatening cardiovascular emergency, of which the long-term impact on health-related quality of life (HRQoL) and male–female-specific insights remain inadequately clarified. Methods: Consecutive adult ATAAD patients who underwent surgery were retrospectively included between 2007 and 2017 in four referral centers in the Netherlands, and baseline data were collected. The 36-Item Short-Form (SF-36) Health Survey was sent to all survivors between 2019 and 2021 and compared to validated SF-36 scores of the Dutch general population stratified by age group and sex. Results: In total, 324/555 surviving patients returned the SF-36 questionnaire (response rate 58%), of which 40.0% were female; the median follow-up was 6.5 years (range: 1.7–13.9, IQR: 4.0–9.4) after surgery for ATAAD. In comparison to the general population, ATAAD patients scored significantly lower on 6/8 SF-36 subdomains and higher on bodily pain. Differences in HRQoL domains compared to the sex-matched data were largely comparable between sexes, apart from bodily pain. In the age-matched subgroups impaired HRQoL was most pronounced in younger patients aged 41–60 (5/8 impaired domains). Female ATAAD patients scored significantly worse on 5/8 SF-36 subdomains and the physical component summary (PCS) scores than male patients. Age at ATAAD, female sex, hypertension, COPD, and prior thoracic aortic aneurysm were associated with worse PCS scores. Conclusions: Long-term HRQoL was impaired in both male and female ATAAD patients when compared to the general population. Further studies on the nature of this impairment and on interventions to improve HRQoL after ATAAD are clearly warranted, with special attention to females and younger patients.

Funder

The Netherlands Organization for Health Research and Development ZonMW

Publisher

MDPI AG

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