Latent profile analysis of quality of life in patients undergoing on-pump cardiac surgery and its perioperative risk factors

Cardiac surgery that uses cardiopulmonary bypass (CPB) is a complex and important procedure, but few studies have examined the quality of life in patients by population stratification. To explore the heterogeneity in quality of life and examine its perioperative risk factors in patients undergoing on-pump cardiac surgery, thereby providing a basis for formulating personalized interventions. The clinical data of patients who underwent on-pump cardiac surgery between January 2019 and December 2023 were retrospectively collected. From July 2024 to December 2024, postoperative telephone follow-up was conducted and the health-related quality of life (HRQoL) was assessed using the 12-Item Short Form Health Survey Version 2 (SF-12v2) scores. Then, latent profile analysis (LPA) identified characteristic categories of HRQoL. Univariate analysis and multivariate logistic regression were employed to determine perioperative factors associated with HRQoL. A total of 427 patients were categorized into low (L group, 19.9%), moderate (M group, 54.1%) and high (H group, 26.0%) HRQoL subgroups, with significant intergroup differences (P < 0.01). Logistic regression analysis revealed that perioperative hypertension, ejection fraction (EF) and duration of mechanical ventilation were significantly associated with HRQoL (P < 0.01) among groups. Compared to H group, preoperative atrial fibrillation was significant in M group (P < 0.01), while postoperative myocardial infarction was significant in L group (P < 0.01). The quality of life is heterogeneous among patients after on-pump cardiac surgery. Perioperative cardiovascular and respiratory factors are closely associated with unfavourable outcomes. Targeted monitoring and management of these modifiable factors may therefore improve HRQoL in high-risk populations. The study has been registered in the Chinese Clinical Trial Registry (ChiCTR2400093824).