title: Can factors related to mortality be used to predict the follow-up health-related quality of life (HRQoL) in cardiac surgery patients?
abstract: BACKGROUND
  Optimal selection of patients and choice of treatment methods in cardiac surgery calls for methods to predict outcome both in terms of mortality and health-related quality of life (HRQoL). Our target was to evaluate whether indicators predicting mortality can also be used to predict follow-up HRQoL.
  
  
  METHODS
  Preoperative and intensive care-related data of 571 elective cardiac surgery patients treated in the Helsinki University Central Hospital were used to predict, in a stepwise (forward) binary logistic regression, the probability of being dead at six months after operation. Furthermore, Tobit regression models were employed to predict the follow-up HRQoL of patients using also treatment complications and patients' experiences of pain and restlessness during treatment as explanatory variables.
  
  
  RESULTS
  The EuroSCORE, renal, respiratory and neurological complications as well as urgent sternotomy were all statistically significant predictors of mortality. By contrast, follow-up HRQoL was predicted by the baseline HRQoL, diabetes and male gender as well as experience of pain and restlessness during the ICU stay.
  
  
  CONCLUSIONS
  Mortality and HRQoL after cardiac surgery appear to be explained by different factors. Pain and restlessness during ICU treatment affect follow-up HRQoL in a negative manner and as potentially modifiable factors, need attention during treatment.
authors.affiliation: Helsinki and Uusimaa Hospital District, Helsinki, Finland. Electronic address: tvainiol@mappi.helsinki.fi.
authors.forename: Tarja
authors.initials: T
authors.lastname: Vainiola
authors.forename: Risto P
authors.initials: RP
authors.lastname: Roine
authors.forename: Raili
authors.initials: R
authors.lastname: Suojaranta-Ylinen
authors.forename: Antti
authors.initials: A
authors.lastname: Vento
authors.forename: Harri
authors.initials: H
authors.lastname: Sintonen
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures; D005260:Female; D006331:Heart Diseases / Q000401:mortality / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011184:Postoperative Period; D011788:Quality of Life
keywords: 15D; Cardiac surgery; Follow up; HRQoL; ICU