Anxiety, depression and health-related quality of life in patients with thoracic aortic disease: a longitudinal study in a cardiothoracic outpatient clinic.

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.