Illness perception profiles and their association with 10-year survival following cardiac valve replacement

Abstract

Background: To evaluate whether profiles of illness perceptions are associated with 10-year survival following cardiac valve replacement surgery. Methods: In a prospective design, illness perceptions were evaluated in 204 cardiac patients awaiting first time valve replacement and again one-year post-operatively using cluster analysis. All-cause mortality was recorded over a 10-year period. At one-year, 136 patients were grouped into one of four profiles (stable positive; stable negative; changed from positive to negative; changed from negative to positive). Findings: The median follow-up was 3063 days (78 deaths). After controlling for clinical covariates including markers of function, and psychological distress, patients who changed illness perceptions from positive to negative beliefs one year post-surgery had an increased mortality risk (HR = 3.2, 95% CI: 1.2 – 8.3, p = .02) compared to patients who held positive stable perceptions. Discussion: Following cardiac valve replacement the development of negative illness perceptions over the first post-operative year predicts long-term mortality. Early screening and intervention to alter this pattern of beliefs could be beneficial and improve outcome.