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Thorac Cardiovasc Surg
DOI: 10.1055/a-2509-0430
Original Cardiovascular

Introduction of Patient-reported Outcome Measures in a Cardiac Surgery Center

Selina Bilger   *
1   Department of Quality Management and Value-based Healthcare, University Hospital Basel, Basel, Switzerland
,
Luca Koechlin   *
2   Department of Cardiac Surgery, University Hospital Basel, Basel, Switzerland
,
Brigitta Gahl
2   Department of Cardiac Surgery, University Hospital Basel, Basel, Switzerland
3   Surgical Outcome Research Center Basel, University Hospital Basel, University Basel, Basel, Switzerland
,
Jules Miazza
2   Department of Cardiac Surgery, University Hospital Basel, Basel, Switzerland
,
Luise Vöhringer
2   Department of Cardiac Surgery, University Hospital Basel, Basel, Switzerland
,
Denis Berdajs
2   Department of Cardiac Surgery, University Hospital Basel, Basel, Switzerland
,
Florian Rüter
1   Department of Quality Management and Value-based Healthcare, University Hospital Basel, Basel, Switzerland
,
Oliver Reuthebuch 
2   Department of Cardiac Surgery, University Hospital Basel, Basel, Switzerland
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Abstract

Background Although patient-reported outcome measures (PROMs) as an integral part of value-based healthcare have important potential for clinical issues, e.g., for shared decision-making, data are limited. Thus, the aim of this study was to report initial results when introducing PROMs in the setting of cardiac surgery.

Methods Patients undergoing elective coronary artery bypass grafting (CABG) were included. Three questionnaires (Seattle Angina Questionnaire 7 [SAQ-7], Rose Dyspnea Scale [RDS], and Patient Health Questionnaire 2 [PHQ-2]) were either administered via iPad (in-hospital) or via a web-based tool (at home). Baseline PROMs were completed at admission. Follow-ups were conducted at 30 days, 1 year, and 2 years postoperatively. We investigated the probability of improvement using multilevel, mixed-effects, ordered logistic regression.

Results Overall, 99 patients answered the questionnaires preoperatively, 84 of whom answered at least one questionnaire postoperatively. No patient died within the hospitalization. Median (IQR) length of stay in the intensive care unit (ICU) was 1.0 (1.0 to 2.0) days. In all dimensions of any PROMs questionnaire, OR was above 1, indicating that most patients reported improvement 1 to 2 years after surgery by at least 1 grade. In the exploratory analysis we found age ≥75 years positively associated with a significantly greater improvement of the SAQ-7 angina frequency and SAQ-7 quality of life score. Length of stay in the ICU showed no significant association with any PROMs at midterm follow-up.

Conclusion In patients undergoing CABG, after a decline within 30 days postoperatively, quality of life–related outcomes improved markedly in a midterm follow-up compared with the preoperative state.

Keywords

quality management - cardiac surgery - PROMs

Ethical Approval Statement

The local ethical committee (EKNZ BASEC Req 2021–02198) approved the study protocol, which is in accordance with the principles of the declaration of Helsinki. The authors designed the study, gathered and analyzed the data, vouched for the data and analysis, wrote the paper, and decided to submit for publication.


* Both the authors contributed equally and should be considered first authors.


Supplementary Material



Publication History

Received: 22 October 2024

Accepted: 30 December 2024

Article published online:
27 January 2025

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