Abstract
Background The rationale of the study was to analyze the impact of age on quality of life (QoL)
in patients who had undergone cardiac surgery with consecutive extracorporeal life
support (ECLS) treatment.
Methods The study population consisted of 200 patients, operated upon between August 2006
and December 2018. The patient cohort was divided into two groups following an arbitrary
cutoff age of 70 years. Comparative outcome analysis was calculated utilizing the
European Quality of Life-5-Dimensions-5-Level Version (EQ-5D-5L).
Results A total of 113 patients were 70 years or less old (group young), whereas 87 patients
were older than 70 years (group old). In 45.7% of cases, the ECLS system was established
during cardiogenic shock and external cardiac massage. The overall survival-to-discharge
was 31.5% (n = 63), with a significantly better survival in the younger patient group (young = 38.9%;
old = 21.8%, p = 0.01). Forty-two patients (66%) responded to the QoL survey after a median follow-up
of 4.3 years. Older patients reported more problems with mobility (y = 52%; o = 88%,
p = 0.02) and self-care (y = 24%; o = 76%, p = 0.01). However, the patients' self-rated health status utilizing the Visual Analogue
Scale revealed no differences (y = 70% [50–80%]; o = 70% [60–80%], p = 0.38). Likewise, the comparison with an age-adjusted German reference population
revealed similar QoL indices. There were no statistically significant differences
in the EQ-5D-5L index values related to sex, number of comorbidities, and emergency
procedures.
Conclusion Despite the limited sample size due to the high mortality rate especially in elderly,
the present study suggests that QoL of elderly patients surviving ECLS treatment is
almost comparable to younger patients.
Keywords
quality of life - geriatric (includes elderly) - extracorporeal membrane oxygenation
- ECMO
