Health-related quality-of-life in patients after elective surgery for abdominal aortic aneurysm

Abstract Purpose: The purpose of this study was to describe the health-related quality-of-life (QoL) in patients after elective surgery for abdominal aortic aneurysm (AAA) compared to a normal population and to study the association between QoL and number of years since surgery. Methods: All Danish men who underwent elective surgery for AAA at the age of 65 or more in the period from 1989-2007 in Denmark were invited to participate in the survey. Of 722 patients, 375 were alive and 328 (87%) responded. The instruments EQ-5D (European Quality of life), EQ-VAS and SF-12 (Short Form Health Survey) were applied for measuring health-related QoL. Multiple regression analysis was used to study the association between QoL and number of years since AAA surgery. Results: A significantly poorer QoL was found in patients having had AAA surgery compared to the normal population as measured with the SF-12 and the EQ-VAS, but not with EQ-5D. A negative association between QoL and years following surgery was found with EQ-VAS and SF-12 (PCS), but not with the other instruments. Discussion: Factors such as selection bias because of mortality and non-response may have resulted in an over-estimate of the QoL in patients having had AAA surgery, thus the difference in QoL compared to the normal population was probably under-estimated. The cross-section design was inefficient for the study of the association between QoL and years since surgery, and EQ-5D may be an insensitive instrument for measuring QoL in AAA patients after surgery. Limitations: The main limitation of the study was the cross-sectional design. Males with a higher risk of death were under-represented in the sample. Conclusion: A poorer quality-of-life was found in patients having had elective AAA surgery compared to the normal population.