In this study, a total of 200 cases met the inclusion criteria, 25 cases did not complete follow-up(4 case of paralysis following acute stroke, 1 case of metastatic cancer, 3 case on dialysis, 14 patients refused to finish questionnaire survey, 3 patients were lost to follow-up), and the remaining 175 cases were devided into Group A (95 patients) and Group B (80 patients). The baseline characteristics of the patients are listed in Table 1. There was no statistical difference in baseline characteristics between the two groups.
Intraoperative and postoperative results
The total average operation time was 310.6 ± 64.8 min. Compared with group B, the operation time in group A was significantly shorter (290.5 ± 87.8 and 346.6 ± 50.5 min, respectively, P = 0.030). Due to aortic regurgitation, 12.0% underwent aortic valve repair, 15.4% underwent aortic valve replacement, with no significant difference between the two groups. In addition, there were no significant differences in bleeding(> 1000 mL / 24 h), double thoracotomy to stop bleeding, secondary tracheal intubation, neurologic dysfuction, acute kidney injury, hepatic insufficiency, multiple organ dysfunction syndrome, and length of hospital stay (LOS) between the two groups. Table 2 lists the detailed intraoperative and postoperative results.
Quality of life
SF-36 questionnaire. Figure 1 shows us the SF-36 scores of patients using modified triple-branched stent graft implantation or frozen elephant trunk surgical technique at different postoperative time points. (1)Among the all eight specific projects of the SF-36, the scores at each time point (at discharge, POM3, and POM12) were all below normal levels. (2)With respect to physical functioning, social function, vitality, bodily pain, and general health, we found no statistically significant difference between the two groups at each time point (at discharge, POM3, and POM12). (3)With respect to role physical, the score was higher in group A than in group B at discharge (P = 0.000) and POM3 (P = 0.000), but no significant difference was found between group A and group B at POM12 (P = 0.279). The score at POM12 in group B was higher than that at discharge (P = 0.000) and at POM3 (P = 0.000), but no significant difference was found between score at discharge and at POM3 (P = 0.566). (4) With respect to social function, the score at POM3 (P = 0.000, 0.000 respectively) and at POM12 (P = 0.000, 0.000 respectively) of two groups were both higher than that at discharge, but no significant difference was found between score at POM3 and at POM12 (P = 0.360, 0.804 respectively). (5) With respect to role emotion, we found no significant difference between the two groups at discharge, and the score of group A was higher than that of group B at POM3 (P = 0.000) and POM12 (P = 0.000). (6) With respect to mental health, group A obtained higher score than group B at any time point (P = 0.000, 0.000, 0.000 respectively).
Self-perceived burden scale
The patients’ Self-Perceived Burden distribution of two groups at different time points is shown in Fig. 2. A total score ≤ 20 means that the patient has no obvious perceived burden, 21 to 30 points means a mild burden, 31 to 40 points means a moderate burden, and > 40 points means a heavy burden. The total score is divided into 2 subgroups: No obvious burden or mild burden were regarded as no impact group, and moderate burden and heavy burden were regarded as impact group. From Fig. 2, we found that group A showed significant difference in self-perceived burden at different follow-up times: as the postoperative time increased, patients influenced by the self-perceived burden gradually decreased, as did Group B. We also found a statistically significant difference at discharge between the two groups: at discharge, the influence of the self-perceived burden of group A was less than that of group B (P = 0.032). However, we found no significant difference between the two groups at POM3 and POM12.
Multiple linear regression analysis of patients’ quality of life
A multiple linear regression analysis of the interfering factors related to QoL was performed one year after discharge. As shown in Table 3, taking the average total score of the SF-36 scale as the dependent variable, preoperative characteristics, intraoperative and post-operative data and self-perceived burden were used as independent variables for multiple linear regression analysis.The result showed that there was a linear regression relationship between the QoL of patients and group, self-perceived burden, age, acute renal failure, LOS, blood loss (> 1000 mL/24 h). Young patients with heavy self-perceived burden, acute renal failure, long LOS and blood loss (> 1000 mL/24 h) in group B seemingly obtained lower QoL.
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