Table 2.

Key characteristics of cardio-thoracic surgery studies (n=17)

First author name	Year	Country	Primary or secondary aim	Sample (N=number of patients in analysis/eligible patients, Nt(i)=sample size per time point, Nc=patients with complications, N1=cases vs N2=controls)	Patient inclusion criteria	Study design	Type of surgery	Surgical complications/method of recording	Psychosocial outcome/time points/measurement tool	Significant association of complications with well-being (yes/no/confounding)	Types of complications and time points of significant effects	Quality assessment score (out of 8)
Deaton	2009	USA	Secondary	Nt1=317/442 Nt2=270 Nc=44% (130)	Patients with documented T2DM undergoing CABG	Observational, cohort, prospective	CABG	Infection of the leg, thorax, sternum, bloodstream or urinary tract; central neurological deficit (stroke or transient ischemia, coma); pneumonia, pulmonary insufficiency with prolonged ventilation or reintubation, pulmonary embolism; renal failure; arrhythmias requiring treatment; prolonged inotropic support or use of intra-aortic balloon pump; or reoperation for bleeding or tamponade/patient records	QoL/3 months post-op/SF-36	Yes	Any complications/3 months postsurgery	6
El Baz	2008	The Netherlands	Secondary	Nt1=198/256 Nt2=168 Nc=?	Consecutive patients who were scheduled for CABG following a coronary angiography	Observational, cohort, prospective	CABG	Postoperative events such as use of inotropes, atrial arrhythmias, or ventricular arrhythmias, sternal resuturing, re-exploration for bleeding, and time spent on mechanical ventilation/registry database, medical notes, outpatient notes and intensive therapy unit charts	QoL/preoperative and 6 months postoperative/SF-36	Yes*	Re-exploration for bleeding and sternal resuturing/6 months postsurgery	8
Ferguson	2009	USA	Primary	N=124/221 Nc=22	Prospective patients who underwent major lung resection for early stage lung cancer.	Observational, cross-sectional	Major lung resection for early stage lung cancer (lobectomy, bilobectomy, pneumonectomy)	Complications were categorised as pulmonary (pneumonia, prolonged intubation, reintubation, air leak more than 7 days, lobar collapse requiring intervention), cardiovascular (pulmonary embolism, myocardial infarction, new postoperative arrhythmia, need for intravenous inotropic agents), other, and any complication/administrative database, hospital medical records, office shadow files	QoL/average of 2.6 years postoperative (3 months to 6.4 years)/EORTC QLQ-C30, EORTC QLQLC13 and DASS-21	Yes	Pulmonary complications/2.6 years postsurgery (range 3 months to 6.4 years)	6
Gjeilo	2010	Norway	Primary	Nt1=534/631 Nt2=462 Nt3=465 Nc(t2)=52	Patients undergoing cardiac surgery	Observational, cohort, prospective	Midline sternotomy	Chronic pain (pain arising after surgery and persisting either continuously or intermittently for 3 months or more/BPI	QoL/preoperative, 6 and 12 months postoperative/SF-36	Yes*	Chronic postsurgical pain/12 months postsurgery	6
Hata	2006	Japan	Secondary	N=452/452 Nc=?	Consecutive adult patients who underwent open heart surgery	Observational, cross-sectional	CABG	Postoperative morbidity (minor stroke, infection, pneumonia, haemodialysis, paraplesis)/patient records	Depression/5–7 days postopertive/interviewed by a psychiatrist and CES-D	Confounding	Postoperative minor stroke and pneumonia/5–7 days postsurgery	6
Jarvinen	2004	Finland	Primary	Nt1=501/1128 Nt2=485 Nc=80	Patients who underwent CABG	Observational, cohort, prospective	CABG (89% via sternotomy incision with cardiopulmonary bypass (CPB; on-pump) and 11% without CPB (off-pump))	Perioperative myocardial infarctions/clinical examination + clinical tests (ECGs, echocardiography, laboratory tests)	QoL/preoperative and 12 months postoperative/RAND-36	Yes*	Perioperative myocardial infarctions /12 months postsurgery	7
Jideus	2009	Sweden	Primary	N1=73/84 (cases) N2=42/? (controls)	Cases: patients who developed SWI after cardiopulmonary bypass Controls: patients prior to CABG and evaluated 1 year postoperative and matched for time of the operation, age and sex	Observational, case–control, cross-sectional	Cardiopulmonary bypass	SWIs: deep infection involving retrosternal tissue and/or the sternal bone)/clinical examination	QoL/20 months postoperative (range 7–40)/SF-36	Yes*	Serious wound infections/20 (range 7–40) months postsurgery	4
Kinney	2012	USA	Primary	N=99 Nt1=120/? Nt2=99 Nc=75	Patients aged 45–75 years undergoing elective thoracotomy	Observational, cohort, prospective	Serratus-sparing posterolateral thoracotomy or limited thoracotomy	Chronic post-thoracotomy pain/Leeds Assessment of Neuropathic Symptoms and Signs + self-reports	QoL/preoperative, 3 months postoperative/SF-36	Yes*	Chronic post-thoracotomy pain/3 months postsurgery	7
Landoni	2006	Italy	Primary	N1=22/42 (cases) N2=40/42 (controls)	Cases: patients who underwent cardiac surgery and developed ARF requiring RRT and left the hospital aliveControls: matched controls who did not develop ARF and did not receive RRT	Observational, case–control, cross-sectional	Cardiac surgery (procedures not specified)	ARF requiring RRT/administrative database, registry	QoL/23–42 months post-op/SF-36	No	NA	6
Le Grande	2006	Australia	Secondary	Nt1=182/444 Nt2=128 Nt3=114 Nc=?	Adults on the waiting list for CABG	Observational, cohort, prospective	CABG	Postsurgical complications such as cardiac arrhythmias, stroke and infections/medical records	QoL/preoperative, 2 and 6 months postoperative/SF-36	Yes*	New cardiac arrhythmia postsurgery, atrial fibrillation/6 months postsurgery	7
Martin	2008	USA	Primary	Nt1=836/2,007 Nt2=2.007 Nc=189	Patients undergoing elective open heart surgery	Observational, cohort, prospective	Open heart surgery (133 valve procedure; 620 CABG; 67 CABG plus valve procedure; 15 CABG plus other cardiac procedure; and 1 closure of an atrial septal defect)	Perioperative myocardial infarction, mediastinitis, superficial wound infection, septicaemia, permanent stroke, transient ischaemic attack, continuous coma, prolonged intubation, ventilator-associated pneumonia, cardiac tamponade, atrial fibrillation, reoperation for bleeding, renal failure, renal failure which required dialysis, and length of stay/method not specified	QoL/preopeative, 1 year postopeative/SF-20	No*	NA	6
Merkouris	2009	Greece	Secondary	Nt1=63/63 Nt2=59 Nt3=56 Nc=42	All patients over 65 presenting a 1, 2 or 3 vessel disease treated with CABG without concurrent procedures (eg, valve replacement)	Observational, cohort, prospective	CABG	Retrospective list of complications: atrial fibrillation, re-exploration for bleeding, low cardiac output syndrome, acute respiratory failure, sternal wound infection, neurological dysfunction, mild problems related to leg incision healing or swelling, chest incision discomfort and medications/method not specified	QoL/preopeative, 4 and 12 months postopeative/MacNew Heart Disease HRQoL questionnaire	No*	NA	5
Moller	2012	Sweden	Secondary	Nt1=249/? Nt2=213 Nc=?	Prospective patients scheduled for lung surgery for lung cancer	Observational, cohort, prospective	Lung surgery	Complication was defined as any of the following postoperative complications: new onset atrial fibrillation, prolonged air leak (chest tubes in place for more than 5 days), pneumonia, reintubation, reoperation, or hospital stay of 8 days or more/method not specified	QoL/preoperative, 6 months postoperative/SF-36	Yes*	Any complications/6 months postsurgery	6
Myles	2001 and 2006	Australia	Secondary	Nt1=120/125 Nt2=120 (days 1, 2, 3) Nt3=108 Nt4=94 Nc=69	Adult cardiac surgical patients	Observational, cohort, prospective	Cardiac surgery (specific procedures not specified)	Respiratory: postoperative mechanical ventilation for more than 24 h or pneumonia, defined as pulmonary infiltrate with positive microbial cultures Cardiac: arrhythmia requiring treatment with antiarrhythmic medication or electrical cardioversion reversion; radiological evidence of pulmonary oedema; or myocardial infarction, defined by new Q waves on ECG or creatine kinase-MB isoenzyme concentration greater than twice normal Renal: acute renal failure, defined by serum creatinine concentration greater than 200 M Neurological: stroke, defined as a new central neurological deficit Sepsis: wound infection requiring excision of tissue or antibiotic therapy, or positive microbial culture (other than pneumonia) Clinical and laboratory tests (microbial cultures, radiological data, ECGs, etc)	QoL/preoperative, 1 and 3 months, 3 years postoperative/SF-36	Confounding*	Any complications/3 months postsurgery	8
Peric	2008	Serbia and Montenegro	Secondary	Nt1=208/? Nt2=192 Nc=60	Consecutive patients who underwent elective CABG	Observational, cohort, prospective	CABG	Retrospective list of complications: low cardiac output (cardiac index lower than 2 L/min/m2), mechanical ventilation longer than 24 h, reoperation for bleeding, sternal wound infection, perioperative myocardial infarction, pericardial effusion, arrhythmic complications (atrial fibrillation, ventricular tachycardia, ventricular fibrillation), abdominal complications, and other/observations, ECGs, echocardiography, laboratory tests	QoL/preoperative, 6 months postoperative/NHP Questionnaire	Yes*	Any complications/6 months postsurgery	7
Rodriguez	2008	USA	Secondary	Nt1=397/? Nt2=? Nt3=? Nt4=? Nc=23	Patients diagnosed with upper extremity hyperhidrosis (HH) treated with thoracic sympathectomy (TS)	Observational, cohort, prospective	Thoracoscopic sympathectomy for palmar and axillary hyperhidrosis	CS: excessive sweating considered abnormal in other parts of the body after TS Gustatory sweating: facial sweating after eating foods Excessive dryness: dryness affecting the hands and requiring hydration Method not specified	QoL/preoperative, discharge, 6 and 12 months postoperative/SF-36	No*	NA	3
Tully	2011	Australia	Primary	Nt1=226/238 Nt2=222 Nc=56	Patients undergoing first-time CABG surgery	Observational, cohort, prospective	CABG	New-onset AF between the patient's day of admission to the intensive care unit and the median day of discharge (day 5) after CABG during the index hospitalisation/ECGs, transthoracic echocardiographs reviewed by technicians and reviewers blinded to patients’ psychological distress scores	Anxiety, depression, stress/preoperative (mean=2 days, SD=2 days) and postoperative (mean=6 days, SD=2 days)/ DASS	Yes*	Atrial fibrillation/6 days (SD=2 days) postsurgery	7

*Study controlled for patients’ preoperative well-being.

ARF, acute renal failure; AF, atrial fibrillation; BPI, Brief Pain Inventory; CES-D, Center for Epidemiological Studies Depression Scale; CS, compensatory sweating; DASS, Depression Anxiety Stress Scales; DASS, Short version of the Depression Anxiety Stress Scales; EORTC QLQLC, European Organisation for Research and Treatment of Cancer core Lung Cancer Questionnaire; HRQoL, health-related quality of life; NA, not available; NHP, Nottingham Health Profile; QoL, quality of life; RRT, renal replacement therapy; SF, Short Form Health Survey; SWI, sternal wound infection; T2DM, type 2 diabetes mellitus.