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Title: Using quality of life and frailty as predictors of recovery in cardiac surgery patients
Author: Abdullahi, Yusuf
ISNI:       0000 0004 9356 6491
Awarding Body: Imperial College London
Current Institution: Imperial College London
Date of Award: 2018
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Background: Frailty is a state characterised by a subclinical decline across multiple organ systems. High frailty is an independent predictor of poor outcome post cardiac surgery. The relationship between patient reported health related quality of life (HRQOL), their frailty status and the impact of cardiac surgeries to their quality of life and functional status has never been investigated in pre and post cardiac surgery. Objective. The objective of this study was to evaluate the relationship between frailty and QoL in pre-and post-cardiac surgery; the predictive value of frailty, pre-cardiac surgery symptoms, comorbidities, and their impact on QoL at four time points post-operatively. Method: The Reported Edmonton Frail Scale (REFS) was applied to all patients to evaluate their frailty score pre-operatively. The influence of frailty to baseline characteristics and quality of life at four time points was calculated. The QoL was assessed in both pre- and post-operatively. Generalised estimation equation (GEE) was applied to measure the influencing factors of quality of life at the four different time points. A wrist worn accelerometer was also applied to patients in order to objectively measure their physical activity levels in both pre-and post-operatively. Results: 105 patients (mean age of 77.22 ± 10.55 years) were successfully enrolled to the study of which 93 (88.57%) patients participated the follow-up period. High frail patients were twice more likely to have longer in-hospital stay than non-frail (Mean 21.2 vs. 9.6 days, p=0.016). The study proved baseline HRQOL has a direct relationship to post-operative HRQOL and survival. Frailty influenced in three out of the four activity levels. Postoperatively, high frail cohorts were more prone to higher complication rates compared to non-frail. Conclusion: The quality of life (QoL) of the vast majority of frail patients improved post cardiac surgery, few may appear to experience poor projection in QoL. Hence, it is inevitable to develop prediction models for recovery and expected improvement in QoL.
Supervisor: Athanasiou, Thanos Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral