Self-Reported Physical Quality of Life Before Thoracic Operations Is Associated With Long-Term Survival.
BACKGROUND
The aim was to analyze the association between baseline self-reported health-related quality of life and long-term survival after thoracic operations.


METHODS
In a prospective population-based cohort study, we included patients scheduled for thoracic operations and obtained information about preoperative health-related quality of life using the validated quality-of-life instrument Short Form-36. Patients were categorized according to higher or lower physical and mental component scores, compared with an age- and sex-matched reference population. The primary outcome measure was all-cause mortality and was ascertained from Swedish national registers. We used Cox regression for estimation of hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between preoperative physical/mental quality of life and long-term survival while adjusting for differences in baseline characteristics, cancer stage, histopathologic process, and other factors.


RESULTS
We included 249 patients between 2006 and 2008. During a median follow-up time of 8.0 years, 119 patients (48%) died. Having a physical component summary score less than reference was significantly associated with mortality (multivariable adjusted HR 2.02, 95% CI: 1.34 to 3.06, p = 0.001). A mental component summary score less than reference was not associated with mortality (adjusted HR 1.32, 95% CI: 0.84 to 3.06, p = 0.233).


CONCLUSIONS
In patients who underwent thoracic operations, a self-reported physical quality of life lower than reference value was associated with significantly worse survival independent of histopathologic process, cancer stage, extent of operations, and other patient-related factors. The preoperative mental component of quality of life was not associated with long-term survival.
Department of Cardiothoracic Surgery and Anesthesiology, Karolinska University Hospital, Stockholm; and Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Mamdoh
M
Al-Ameri
Department of Cardiothoracic Surgery and Anesthesiology, Karolinska University Hospital, Stockholm; and Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Per
P
Bergman
Department of Cardiothoracic Surgery and Anesthesiology, Karolinska University Hospital, Stockholm; and Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Anders
A
Franco-Cereceda
Department of Cardiothoracic Surgery and Anesthesiology, Karolinska University Hospital, Stockholm; and Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. Electronic address: ulrik.sartipy@karolinska.se.
Ulrik
U
Sartipy
D000368:Aged; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods; D057234:Preoperative Period; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011788:Quality of Life; D057566:Self Report; D015996:Survival Rate; D013548:Sweden; D019616:Thoracic Surgical Procedures / Q000379:methods / Q000401:mortality*; D016896:Treatment Outcome