The Essential Difference in Measuring Health Status and Quality of Life in Patients with an Abdominal Aortic Aneurysm

B Gjosha; W van Wel; J de Vries; S Steunenberg; N Verbogt; G H Ho; H G W de Groot; E J Veen; M G Buimer; L van der Laan

doi:10.1016/j.avsg.2025.04.131

The Essential Difference in Measuring Health Status and Quality of Life in Patients with an Abdominal Aortic Aneurysm

Ann Vasc Surg. 2025 May 9:120:172-180. doi: 10.1016/j.avsg.2025.04.131. Online ahead of print.

Authors

B Gjosha¹, W van Wel², J de Vries³, S Steunenberg⁴, N Verbogt⁴, G H Ho⁴, H G W de Groot⁴, E J Veen⁴, M G Buimer⁴, L van der Laan⁵

Affiliations

¹ Department of Vascular Surgery, Amphia Hospital, Breda, The Netherlands. Electronic address: bgjosha2@amphia.nl.
² Erasmus University Rotterdam, Rotterdam, The Netherlands.
³ Admiraal de Ruyter Hospital, Goes, The Netherlands; Tilburg University, Tilburg, The Netherlands.
⁴ Department of Vascular Surgery, Amphia Hospital, Breda, The Netherlands.
⁵ Department of Vascular Surgery, Amphia Hospital, Breda, The Netherlands; TIAS School for Business and Society, Tilburg, The Netherlands; Department of Cardiovascular Sciences, Vascular Surgery Research Group, KU Leuven, Leuven, Belgium.

PMID: 40349835
DOI: 10.1016/j.avsg.2025.04.131

Abstract

Background: Quality of life (QoL) and health status (HS) are important patient-reported outcomes following abdominal aortic aneurysm (AAA) repair. In current literature, HS questionnaire outcomes are often reported as health-related QoL, although they primarily measure functional outcomes. The literature on actual QoL in AAA patients is limited. This study evaluated QoL and HS in AAA patients after aneurysm repair, including both open surgical repair (OSR) and endovascular aneurysm repair (EVAR).

Methods: This prospective observational cohort study included AAA patients from a prehabilitation program between 2018 and 2022. QoL was assessed using the WHOQOL-BREF, and HS using the SF-12 questionnaire, at baseline (before surgery), 6 months, and 12 months postoperatively. Changes in QoL and HS over time were evaluated using linear mixed models that adjusted for sex and type of surgery.

Results: Of the 91 included patients, 38 underwent OSR and 53 underwent EVAR, with a mean age of 76.7 years. Compared to baseline, overall QoL was significantly lower at 12 months follow-up (mean difference -0.24, P = 0.023). Group analysis revealed a significant decline in overall QoL in EVAR patients only. No significant change in QoL following OSR was observed. No significant change in HS was observed in either group.

Conclusion: The findings suggest that the WHOQOL-BREF questionnaire is more appropriate for evaluating QoL in AAA patients. Overall QoL, rather than HS, significantly declined between baseline and postoperative follow-up in older prehabilitated AAA patients, especially after EVAR. Understanding the impact of surgical interventions beyond traditional HS measures is crucial for shared decision-making and value-based healthcare.