Association of Major Surgical Admissions With Quality of Life: 19-Year Follow-up of the Whitehall II Longitudinal Prospective Cohort Study

Abstract

This cohort study examines major surgical admissions and quality of life. While surgery can be lifesaving and prolonging, its association with quality of life needs further investigation. Some studies suggest that surgery is associated with both physical and mental function, while others emphasize its outcome on physical function alone.1,2 Few studies have conducted prospective, long-term follow-up, and to our knowledge, no studies account for the preadmission trajectory of physical and mental function. This is critical, as preoperative functional status is associated with the potential for improvement.3 Furthermore, the sample sizes in these studies are typically small and focused on a single institution or small groups of centers.4 These limitations highlight the need for analysis of larger, longitudinal studies. Given our 2019 report of subtle cognitive decline after surgery,5 we aimed to clarify the association of medical and surgical admissions with the trajectory of quality of life, considering both mental and physical function. As surgical and medical illnesses may cluster, it is important to consider the independent associations of each.