Self-Reported Physical Quality of Life Before Thoracic Operations Is Associated With Long-Term Survival.

Background. The aim was to analyze the association between baseline self-reported health-related quality of life and long-term survival after thoracic operations. Methods. In a prospective population-based cohort study, we included patients scheduled for thoracic operations and obtained information about preoperative health-related quality of life using the validated quality of life instrument Short Form-36. Patients were categorized according to higher or lower physical and mental component scores, compared with an age-and sex-matched reference population. The primary outcome measure was all-cause mortality and was ascertained from Swedish national registers. We used Cox regression for estimation of hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between preoperative physical/mental quality of life and long-term survival while adjusting for differences in baseline characteristics, cancer stage, histopathologic process, and other factors. Results. We included 249 patients between 2006 and 2008. During a median follow-up time of 8.0 years, 119 patients (48%) died. Having a physical component summary score less than reference was significantly associated with mortality (multivariable adjusted HR 2.02, 95% CI: 1.34 to 3.06, p= 0.001). A mental component summary score less than reference was not associated with mortality (adjusted HR 1.32, 95% CI: 0.84 to 3.06, p = 0.233). Conclusions. In patients who underwent thoracic operations, a self-reported physical quality of life lower than reference value was associated with significantly worse survival independent of histopathologic process, cancer stage, extent of operations, and other patientrelated factors. The preoperative mental component of quality of life was not associated with long-term survival. (Ann Thorac Surg 2017; 103: 484-90) (C) 2017 by The Society of Thoracic Surgeons