For decades cardiac surgery has been evaluated based on outcomes such as mortality, complications and recurrence of symptoms. Other important outcomes from the patient's perspective, were less considered, but in addition to rapidly improving surgical techniques and the low mortality after surgery, the focus is increasingly shifting to patient-reported outcomes. The studies described in this thesis have been conducted to gain insight into patient-reported outcomes after cardiac surgery, including quality of life, cognitive functioning and return to work.
The various studies in this thesis show that undergoing cardiac surgery has a great impact on patient's daily lives. Younger patients often need six months or more to resume work. Physical and emotional complaints are common problems in the process of resuming work, as are the lack of, or conflicting advice given by, the healthcare professionals involved. In addition, the study results show that many patients do not improve in terms of quality of life after cardiac surgery and elderly patients in particular, are more at risk of a deterioration in their postoperative quality of life. To be able to honestly inform patients about what they can expect after surgery, it is important to discuss the preoperative quality of life and the expectations of the patient regarding quality of life before surgery. Especially in frail elderly patients, where a small decline can have important consequences for daily life, it is important to discuss this topic during preoperative shared decision making.