Changes in health after elective percutaneous coronary revascularization. A comparison of generic and specific measures.
OBJECTIVE
This study determines changes in health-related quality of life after elective percutaneous transluminal coronary angioplasty and compares generic and specific measures.


METHODS
Changes in health-related quality of life were measured in consecutive, symptomatic patients undergoing elective percutaneous coronary revascularization using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), the Specific Activity Scale (SAS), and the Canadian Cardiovascular Society Classification (CCSC). The patients were interviewed as outpatients before admission and at least 6 months later.


RESULTS
There were significant changes in the following SF-36 measures: physical functioning (postscore minus prescore = 19.1 +/- 24.1), role limitations due to physical-health problems (40.4 +/- 47.2), bodily pain (19.9 +/- 29.3), vitality (12.9 +/- 25.1), social functioning (20.0 +/- 33.1), role limitations due to emotional-health problems (26.7 +/- 49.0), and general mental health (7.1 +/- 21.2). General health perceptions did not change significantly. Internal-consistency reliability coefficients for these measures ranged from 0.73 to 0.91. There also was significant improvement in the CCSC class, but the SAS class did not change significantly. Overall, the SF-36 role-physical scale was the most responsive to changes after elective percutaneous coronary revascularization, followed by the CCSC and the SF-36 physical functioning scale.


CONCLUSIONS
Although this study cannot determine the causal role of elective percutaneous coronary revascularization in these changes, it provides support for the usefulness of these measures in future evaluations of this intervention.
Krumholz
H M
HM
Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT 06520-8017, USA.
McHorney
C A
CA
Clark
L
L
Levesque
M
M
Baim
D S
DS
Goldman
L
L
D000203:Activities of Daily Living; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000523:psychology; D001900:Boston; D017558:Elective Surgical Procedures; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011788:Quality of Life; D015203:Reproducibility of Results; D012803:Sick Role; D011795:Surveys and Questionnaires / Q000592:standards; D013997:Time Factors