Frontiers in cardiovascular medicine · 2026
Anxiety, depression and health-related quality of life in patients with thoracic aortic disease: a longitudinal study in a cardiothoracic outpatient clinic.
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Dalyanoglu Ismail, Markser Anna Maria, Nienhaus Johannes, Yilmaz Esma, Morjan Mohammed, Thwairan Amin, Dinger Ulrike, Lichtenberg Artur, Dalyanoglu Hannan
Аннотация
BACKGROUND: Thoracic aortic diseases (TAD) require complex surgical and longitudinal follow-up care. Evidence on health-related quality of life (HRQoL) and psychological distress in real-world TAD outpatient cohorts remains limited.
OBJECTIVE: To describe longitudinal trajectories of HRQoL and psychological distress in patients with TAD and to examine associations with key demographic and clinical variables.
METHODS: We retrospectively analyzed 111 patients (256 visits, 2023-2025). Primary outcomes were EQ-5D-5L index values, EQ-VAS scores, and PHQ-4 total scores. Linear mixed-effects models (random intercepts for patient ID) and logistic regression (PHQ-4 ≥6) were used to account for repeated measures. Primary predictors included sex, surgical status, and time since surgery; age and visit number were examined exploratorily.
RESULTS: Median EQ-5D-5L was 0.71 (IQR 0.55-0.88), EQ-VAS 70 (60-80), and PHQ-4 3 (1-5). Time since surgery predicted HRQoL improvement (β > 0, p < 0.001). Preoperative patients showed lower HRQoL (β < 0, p < 0.01) and twice the odds of clinically relevant distress (OR 2.0, 95% CI 1.2-3.3). Female sex showed nonsignificant trends toward lower HRQoL and higher distress.
CONCLUSIONS: Preoperative TAD patients reported lower HRQoL and higher distress, while postoperative recovery was associated with gradual improvement. Findings reflect real-world patterns in a mixed pre-/postoperative outpatient cohort and support integrating brief psychosocial screening into routine TAD follow-up.
OBJECTIVE: To describe longitudinal trajectories of HRQoL and psychological distress in patients with TAD and to examine associations with key demographic and clinical variables.
METHODS: We retrospectively analyzed 111 patients (256 visits, 2023-2025). Primary outcomes were EQ-5D-5L index values, EQ-VAS scores, and PHQ-4 total scores. Linear mixed-effects models (random intercepts for patient ID) and logistic regression (PHQ-4 ≥6) were used to account for repeated measures. Primary predictors included sex, surgical status, and time since surgery; age and visit number were examined exploratorily.
RESULTS: Median EQ-5D-5L was 0.71 (IQR 0.55-0.88), EQ-VAS 70 (60-80), and PHQ-4 3 (1-5). Time since surgery predicted HRQoL improvement (β > 0, p < 0.001). Preoperative patients showed lower HRQoL (β < 0, p < 0.01) and twice the odds of clinically relevant distress (OR 2.0, 95% CI 1.2-3.3). Female sex showed nonsignificant trends toward lower HRQoL and higher distress.
CONCLUSIONS: Preoperative TAD patients reported lower HRQoL and higher distress, while postoperative recovery was associated with gradual improvement. Findings reflect real-world patterns in a mixed pre-/postoperative outpatient cohort and support integrating brief psychosocial screening into routine TAD follow-up.