title: Comparison of patient-reported outcomes after elective coronary artery bypass grafting in patients aged greater than or equal to and less than 65 years.
abstract: Older patients represent a growing proportion of patients undergoing coronary artery bypass grafting (CABG). Although functional benefits after CABG have been demonstrated, most assessments of outcomes have involved patients aged less than 65 years. Therefore, little is known concerning the impact of CABG on older patients compared with that on younger ones. A number of postsurgical (6 months) health-related quality-of-life outcomes (e.g., symptoms, cardiac functional class, instrumental activities of daily living, and emotional and social functioning) reported by patients aged less than 65 (n = 169) and greater than or equal to 65 (n = 99) years who underwent elective CABG at 4 major teaching hospitals in Massachusetts and California were compared. The proportion of patients reporting cardiac-related symptoms after surgery did not vary by age, and quality-of-life outcome scores of younger and older patients did not differ even after adjustment for clinical and demographic characteristics. The exception to this was mental health status, an outcome for which older patients reported better functioning than did younger ones. On average, patients in the 2 age groups reported equivalent improvement over preadmission status in instrumental activities of daily living, and emotional and social functioning. The independent relation of clinical and sociodemographic factors to quality-of-life outcomes was also investigated. Patients who functioned better before admission, those with less severe co-morbid disease, and married patients reported better functioning after discharge. In general, older patients who underwent elective CABG reported functional benefits similar to those reported by younger ones, and the factors associated with better functioning did not vary by age group.
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts 02115.
authors.forename: E
authors.initials: E
authors.lastname: Guadagnoli
authors.forename: J Z
authors.initials: JZ
authors.lastname: Ayanian
authors.forename: P D
authors.initials: PD
authors.lastname: Cleary
mesh_terms: D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D001026:Coronary Artery Bypass; D005260:Female; D015577:Geriatric Assessment; D006304:Health Status; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome