PURPOSE: This study evaluated and compared changes over time in health-related quality of life reported by patients with infrarenal
abdominal aortic aneurysm (AAA) undergoing elective endovascular (
EVAR) and open
aneurysm (OR) repair. METHODS: A prospective, nonrandomized cohort of 76 patients (62 men, 14 women; age range, 42 to 89 years) undergoing elective, infrarenal AAA repair (
EVAR, n = 43; OR, n = 33) at two university teaching hospitals during a 15-month period were administered the Medical Outcomes Study Short-Form 36-item (SF-36) health survey preoperatively and then 1 week, 1 month, and 6 months postoperatively. Patient demographics, procedural details, postoperative follow-up data, and SF-36 scores were compared between groups. RESULTS: Both groups had total SF-36 scores that were significantly lower than preoperative scores at 1 week and 1 month after
surgery but were not significantly different from the preoperative scores at 6 months (OR 66.2 +/- 21.1 to 72.3 +/- 19.8, P > .1; and
EVAR 61.0 +/- 17.7 to 58.7 +/- 19.4, P > .1). Six-month total SF-36 scores were significantly higher in the OR group compared with the
EVAR group (
mean 72.3 +/- 19.8 OR vs 58.7 +/- 19.4
EVAR; P = .009). In the postoperative period, a significant drop occurred in
mean scores in six of the eight domains of the SF-36 in the OR patients (physical function, PF; role physical, RP; bodily
pain, BP; vitality, VT; social function, SF; role
emotional, RE) and five domains for
EVAR patients (PF, RP, BP, SF, RE). In two domains, RE and PF, scores returned to baseline values significantly sooner in
EVAR patients than in OR patients (RE,
EVAR 1 month vs OR 6 months; and PF,
EVAR 1 month vs OR 6 months). In the VT domain, no significant postoperative drop occurred in the
EVAR group, but in the OR group,
mean scores were significantly lower at 1 week and 1 month compared with preoperative values. In the domains of general health and mental health, no significant drop occurred in SF-36 score postoperatively in either group. CONCLUSIONS: Patient reported health-related quality of life after infrarenal AAA repair is significantly
impaired in the early postoperative period but returns to baseline by 6 months in patients treated with
EVAR and OR. Patients having
EVAR had significantly more rapid return to preoperative scores in
selected domains of the SF-36. Even though
EVAR is associated with shorter and less invasive perioperative hospital course and fewer postoperative complications,
EVAR patients had lower quality of life scores 6 months after
surgery than OR patients.
