Quality of Life, Anxiety and Depression after Acute Type B Aortic Dissection

Eva Torbjörnsson; Olga Nilsson; Malin Stenman; Christian Olsson; Johnny Steuer; Rebecka Hultgren; Christian Smedberg

doi:10.1016/j.avsg.2024.11.097

Quality of Life, Anxiety and Depression after Acute Type B Aortic Dissection

Ann Vasc Surg. 2024 Dec 16:112:157-165. doi: 10.1016/j.avsg.2024.11.097. Online ahead of print.

Authors

Eva Torbjörnsson¹, Olga Nilsson², Malin Stenman³, Christian Olsson³, Johnny Steuer⁴, Rebecka Hultgren², Christian Smedberg⁴

Affiliations

¹ Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Department of Surgery, Södersjukhuset, Stockholm, Sweden. Electronic address: [email protected].
² Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Department of Vascular Surgery, Karolinska University Hospital, Stockholm, Sweden.
³ Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Department of Cardiothoracic Surgery, Karolinska University Hospital, Stockholm, Sweden.
⁴ Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Department of Surgery, Södersjukhuset, Stockholm, Sweden.

PMID: 39694189
DOI: 10.1016/j.avsg.2024.11.097

Abstract

Background: Type B aortic dissection (TBAD) is an acute cardiovascular emergency but also a condition warranting life-long surveillance. The long-term consequences on physical and mental well-being are largely unknown. The primary aim was to analyze self-reported Health-Related Quality of Life (HRQoL) and symptoms of anxiety and depression in patients with chronic TBAD. The secondary aim was to describe changes in physical and sexual activity following TBAD.

Methods: This is a population-based cross-sectional survey study. All patients hospitalised with acute TBAD in Stockholm County 2017-2021, and alive on March 31, 2023, were invited to answer questionnaires on HRQoL (EQ-5D-5L, EQ VAS), anxiety (HADS-A), depression (HADS-D), physical activity (SED-GIH) and sexual activity (men: IIEF-5, women: FSFI-6).

Results: Out of 88 invited TBAD patients, 49 (56%) participated. Median age was 72 years (IQR 62-81) and 41% were women. The median time from the acute event to the questionnaire response was 42 months (IQR 27-60). The mean EQ VAS score was 62. The largest negative impacts on the participants health status were seen in the "pain/discomfort" (66% of participants), "anxiety/depression" (53%) and "Mobility" (45%) domains. Based on the HADS questionnaire, 20% had a score indicating symptoms of depression, whereas 14% had a score indicating symptoms of anxiety. Overall, 69% reported a change in physical activity and 42% reported a change in sexual activity.

Conclusions: TBAD patients reported substantially reduced mental and physical well-being several years after the acute event. This new and important finding should be considered by health-care providers and in future follow-up protocols.