Quality of Life Research

, Volume 26, Issue 9, pp 2421–2434 | Cite as

Impact of marital status and comorbid disorders on health-related quality of life after cardiac surgery

  • Ann Kristin BjørnnesEmail author
  • Monica Parry
  • Ragnhild Falk
  • Judy Watt-Watson
  • Irene Lie
  • Marit Leegaard



To explore associations between HRQL, marital status, and comorbid disorders in men and women following cardiac surgery.


A secondary analysis was completed using data from a randomized controlled trial in which 416 individuals (23% women) scheduled for elective coronary artery bypass graft and/or valve surgery were recruited between March 2012 and September 2013. HRQL was assessed using the Health State Descriptive System (15D) preoperatively, then at 2 weeks, and at 3, 6, and 12 months following cardiac surgery. Linear mixed model analyses were performed to explore associations between HRQL, social support, and comorbid disorders.


The overall 15D scores for the total sample improved significantly from 2 weeks to 3 months post surgery, with only a gradual change observed from 3 to 12 months. Thirty percent (n = 92) of the total sample reported a lower 15D total score at 12 months compared to preoperative status, of whom 78% (n = 71) had a negative minimum important differences (MID), indicating a worse HRQL status. When adjusted for age and marital status, women had statistically significant lower 15D total scores compared to men at 3, 6, and 12 months post surgery. Compared to pre-surgery, improvement was demonstrated in 4 out of 15 dimensions of HRQL for women, and in 6 out of 15 dimensions for men at 12 months post surgery. Both men and women associated back/neck problems, depression, and persistent pain intensity with lower HRQL; for women, not living with a partner/spouse was associated with lower HRQL up to 12 months.


Women experienced decreased HRQL and a slower first-year recovery following cardiac surgery compared to men. This study demonstrates a need for follow-up and support to help women manage their symptoms and improve their function within the first year after cardiac surgery. This was particularly pronounced for those women living alone.


Health-related quality of life Cardiac surgery Gender differences Marital status Social support Comorbidity 



Grant support from South-Eastern Norway Regional Health Authority (2012030).

Compliance with ethical standards

Conflict of interest

No conflict of interest has been declared by the authors.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Ethics approval was obtained from Regional Committee for Medical Research Ethics in Eastern Norway (no. 2011/2012 A) and Social Science Data Services at Oslo University Hospital (no. 2012/16916). Clinical Trials gov Identifier: NCT01976403.

Informed consent

All eligible participants received oral and written information about the study and provided written informed consent to participate. Participants were informed that they could withdraw from the study at any time during the study period without giving reasons.


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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Lawrence S. Bloomberg Faculty of NursingUniversity of TorontoTorontoCanada
  2. 2.Division of Emergencies and Critical Care, Department of Research and DevelopmentOslo University HospitalOsloNorway
  3. 3.Oslo Centre for Biostatistics and Epidemiology, Research Support ServicesOslo University HospitalOsloNorway
  4. 4.Division of Cardiovascular and Pulmonary Diseases, Department of Cardiothoracic Surgery, Ullevål/Center for Patient Centered Heart- and Lung ResearchOslo University HospitalOsloNorway
  5. 5.Faculty of Health Sciences, Institute of NursingOslo and Akershus University College of Applied SciencesOsloNorway

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