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Background <p>Chest scars after cardiac surgery may be especially important for body image and health-related quality of life (HRQoL) in younger adults, but the impact of minimally invasive versus sternotomy access on these outcomes remains unclear.</p> Objective <p>To compare body image and HRQoL after minimally invasive versus sternotomy cardiac surgery in adults younger than 60 years and to explore whether body image may be associated with the relationship between access route and HRQoL.</p> Methods <p>In this retrospective cross-sectional study, 47 patients younger than 60 years who had undergone cardiac surgery 4–22 months earlier completed structured interviews. Body image was assessed with the Body Esteem Scale and summarized as a gender-standardized Body Image Score. HRQoL was measured using the EQ-5D-5&#xa0;L Index Value and EQ-VAS. Nonparametric group comparisons, correlation and regression analyses, and exploratory mediation analysis with bootstrapped confidence intervals were conducted.</p> Results <p>EQ-5D Index Values and EQ-VAS scores did not differ significantly between access routes. Patients after minimally invasive surgery reported higher satisfaction with chest appearance and tended to report more favorable overall body image. Body image was positively associated with both HRQoL indicators and predicted HRQoL in regression models. Exploratory mediation analysis was inconclusive: bootstrap confidence intervals suggested a possible indirect association between surgical approach and EQ-5D Index Values via body image, but the corresponding z-based test was not statistically significant.</p> Conclusions <p>In younger adults after cardiac surgery, minimally invasive access was associated with more favorable perceptions of chest appearance, while overall HRQoL was similar across groups. Body image was associated with HRQoL and may represent a relevant psychosocial factor to consider in postoperative care and shared decision making. Further prospective studies are needed to clarify its role.</p>

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Minimally invasive versus sternotomy cardiac surgery in younger adults: the role of body image in health-related quality of life

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年7月7日

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  • Aleksandra Stańska,
  • Zuzanna Korpacka,
  • Julia Linda,
  • Anna Michalonek,
  • Andrzej Klapkowski,
  • Maciej Brzeziński

摘要

Background

Chest scars after cardiac surgery may be especially important for body image and health-related quality of life (HRQoL) in younger adults, but the impact of minimally invasive versus sternotomy access on these outcomes remains unclear.

Objective

To compare body image and HRQoL after minimally invasive versus sternotomy cardiac surgery in adults younger than 60 years and to explore whether body image may be associated with the relationship between access route and HRQoL.

Methods

In this retrospective cross-sectional study, 47 patients younger than 60 years who had undergone cardiac surgery 4–22 months earlier completed structured interviews. Body image was assessed with the Body Esteem Scale and summarized as a gender-standardized Body Image Score. HRQoL was measured using the EQ-5D-5 L Index Value and EQ-VAS. Nonparametric group comparisons, correlation and regression analyses, and exploratory mediation analysis with bootstrapped confidence intervals were conducted.

Results

EQ-5D Index Values and EQ-VAS scores did not differ significantly between access routes. Patients after minimally invasive surgery reported higher satisfaction with chest appearance and tended to report more favorable overall body image. Body image was positively associated with both HRQoL indicators and predicted HRQoL in regression models. Exploratory mediation analysis was inconclusive: bootstrap confidence intervals suggested a possible indirect association between surgical approach and EQ-5D Index Values via body image, but the corresponding z-based test was not statistically significant.

Conclusions

In younger adults after cardiac surgery, minimally invasive access was associated with more favorable perceptions of chest appearance, while overall HRQoL was similar across groups. Body image was associated with HRQoL and may represent a relevant psychosocial factor to consider in postoperative care and shared decision making. Further prospective studies are needed to clarify its role.