Health-related quality of life as a predictor of mortality following coronary artery bypass graft surgery. Participants of the Department of Veterans Affairs Cooperative Study Group on Processes, Structures, and Outcomes of Care in Cardiac Surgery.
BACKGROUND
Health-related quality of life has not been evaluated as a predictor of mortality following coronary artery bypass graft (CABG) surgery. Evaluation of health status as a mortality predictor may be useful for preoperative risk stratification.


OBJECTIVE
To determine whether the Physical and Mental Component Summary scores from the preoperative Short-Form 36 (SF-36) health status survey predict mortality following CABG surgery after adjustment for known clinical risk variables.


METHODS
Prospective cohort study conducted between September 1992 and December 1996.


METHODS
Fourteen Veterans Affairs hospitals.


METHODS
Of the 3956 patients undergoing CABG surgery only and who were enrolled in the Processes, Structures, and Outcomes of Care in Cardiac Surgery study, the 2480 who completed a preoperative SF-36.


METHODS
All-cause mortality within 180 days after surgery.


RESULTS
A total of 117 deaths (4.7%) occurred within 180 days of CABG surgery. The Physical Component Summary of the preoperative SF-36 was a statistically significant risk factor for 6-month mortality after adjustment for known clinical risk factors for mortality following CABG surgery. In multivariate analysis, a 10-point lower SF-36 Physical Component Summary score had an odds ratio (OR) of 1.39 (95% confidence interval [CI], 1.11-1.77; P=.006) for predicting mortality. The SF-36 Mental Component Summary score was not associated with 6-month mortality in multivariate analyses (OR, 1.09; 95% CI, 0.92-1.29; P=.31).


CONCLUSIONS
The Physical Component Summary score from the preoperative SF-36 is an independent risk factor for mortality following CABG surgery. The baseline Mental Component Summary score does not appear to be predictive of mortality. Preoperative patient self-report of the physical component of health status may be helpful for risk stratification and clinical decision making for patients undergoing CABG surgery.
Rumsfeld
J S
JS
Division of Cardiology, Health Sciences Center, University of Colorado, Denver, USA. John.Rumsfeld@med.va.gov
MaWhinney
S
S
McCarthy
M
M
Shroyer
A L
AL
VillaNueva
C B
CB
O'Brien
M
M
Moritz
T E
TE
Henderson
W G
WG
Grover
F L
FL
Sethi
G K
GK
Hammermeister
K E
KE
D001026:Coronary Artery Bypass / Q000401:mortality*; D005260:Female; D006787:Hospitals, Veterans; D006801:Humans; D016013:Likelihood Functions; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011788:Quality of Life; D018570:Risk Assessment; D018434:Sickness Impact Profile; D018709:Statistics, Nonparametric; D014481:United States