Outcomes of coronary artery bypass surgery in elderly people.
OBJECTIVE
To document the impact of coronary artery bypass (CABG) surgery on quality of life in elderly people three months after surgery; to compare quality of life measures; to examine predictors of poor quality of life; and to assess the predictive validity of global clinical rating scales.


METHODS
Prospective cohort study with postoperative, three-month and one-year follow-up.


METHODS
A 700-bed tertiary care teaching hospital in Halifax, Nova Scotia.


METHODS
One hundred of 200 consecutive patients, 75 years and older, undergoing CABG.


METHODS
Demographic information, clinical data and global clinical ratings were collected at baseline to assess risk for adverse outcome (death, stroke, functional impairment) at each follow-up. Quality of life three months post-CABG was documented using the RAND 36-Item Health Survey and the Seattle Angina Questionnaire.


RESULTS
Perioperative deaths occurred in four patients, disabling strokes in six and postoperative complications in seven. Three additional deaths occurred by the three-month follow-up and nine more by one year. On average, important improvements in quality of life were observed at three months' follow-up, using both assessments of quality of life.


CONCLUSIONS
Many elderly patients do well after CABG surgery, but a higher proportion than is seen in younger patients have complications leading to death and disability. A global clinical measure by the attending cardiologist at baseline did not identify patients at a higher risk. Follow-up studies are needed to assess long term outcomes of older patients at higher risk of death or a poor quality of life after CABG surgery.
MacDonald
P
P
Division of Cardiology, Dalhousie University, Halifax, Nova Scotia.
Stadnyk
K
K
Cossett
J
J
Klassen
G
G
Johnstone
D
D
Rockwood
K
K
D000368:Aged; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders / Q000209:etiology; D001026:Coronary Artery Bypass / Q000401:mortality; D003327:Coronary Disease / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D007902:Length of Stay; D008297:Male; D016017:Odds Ratio; D011183:Postoperative Complications; D011446:Prospective Studies; D011788:Quality of Life; D015996:Survival Rate; D016896:Treatment Outcome