title: Health-related quality of life after cardiac transplantation: results of a UK National Survey with Norm-based Comparisons.
abstract: BACKGROUND
  Health-related quality of life (HRQOL) is an important measure of outcome that is known to improve after cardiac transplantation, and some studies have suggested that the HRQOL approaches levels found in normal populations. This study presents descriptive analyses of HRQOL and norm-based comparisons after cardiac transplantation in the UK.
  
  
  METHODS
  A cross-sectional postal survey of cardiac transplant recipients at their first-, third- or fifth-year anniversary after transplantation was undertaken using the Short Form-36 (SF-36), EuroQol (EQ-5D) and Hospital Anxiety and Depression Scale (HADS) questionnaires. Data from the SF-36 and EQ-5D were then compared with normative data from the UK.
  
  
  RESULTS
  Of 429 questionnaires issued, 323 were completed and returned, a response rate of 75%. One year after surgery, 66% and 28% of respondents reported much better and somewhat better health, respectively. No deterioration in general health was reported at 3 and 5 years after transplantation. Norm-based comparisons suggested significantly poorer (p < 0.05) HRQOL for the EQ-5D and all dimensions of the SF-36 except mental health. Data from the HADS showed that 89% of respondents had symptoms compatible with normality or mild depression. There was no statistically significant difference in HRQOL between respondents at 1, 3 or 5 years after transplantation for any of the dimensions tested.
  
  
  CONCLUSIONS
  Cardiac transplant recipients in the UK indicated an improvement in general health after transplantation. Respondents at 3 and 5 years after transplantation reported stability, or improvement, but no deterioration in their general health. Norm-based comparisons suggested lower HRQOL for all dimensions except mental health. Some dimensions of health identified in this study may be areas for further investigation that may ultimately be amenable to focused medical management.
authors.affiliation: UK Cardiothoracic Transplant Audit, Clinical Effectiveness Unit, The Royal College of Surgeons of England, London, UK. imran@blossoms21.freeserve.co.uk
authors.forename: Imran
authors.initials: I
authors.lastname: Saeed
authors.forename: Chris
authors.initials: C
authors.lastname: Rogers
authors.forename: Andrew
authors.initials: A
authors.lastname: Murday
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors; D006113:United Kingdom