Perceived health status in patients over 70 before and after open-heart operations.
OBJECTIVE
to evaluate improvement and predictors of improvement in patients' perceived health status after cardiac surgery in older patients.


METHODS
three hundred and seventy-seven patients from three different departments of cardiac surgery completed the Nottingham Health Profile questionnaire before and 1 and 2 years after open-heart surgery. We analysed pre- and postoperative data and pre- and postoperative Nottingham Health Profile scores.


RESULTS
the mean age was 74+/-3 years. The comparison between pre- and postoperative scores showed an improvement in all but the social isolation section. Logistic regression showed that the predictors of patients who became worse after surgery were (i) in the energy section: age over 75 [odds ratio (OR) = 1.8, 95% confidence interval (CI) = 1.02-3.2], coronary artery disease (OR = 2.4, 95% CI = 1.04-3.6) and postoperative events (OR = 1.9, 95% CI = 1.01-3.7); (ii) in the physical mobility section: diabetes mellitus (OR = 2.4, 95% CI = 1.2-4.7); and (iii) in the social isolation section: physical mobility impairment (OR = 3.4, 95% CI = 1.3-8.7).


CONCLUSIONS
cardiac surgery improves perceived health status in patients over 70. This improvement is better for those undergoing aortic valve replacement than for those undergoing coronary artery bypass surgery. Comparison with reference scores for a standard population shows that, even when successful, cardiac surgery results in fatigue and persistent sleep disturbance in older patients.
Chocron
S
S
Department of Thoracic and Cardiovascular Surgery, Hôpital Jean Minjoz, Besançon, France. chocron@usa.net
Tatou
E
E
Schjoth
B
B
Naja
G
G
Clement
F
F
Viel
J F
JF
Etievent
J P
JP
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D011182:Postoperative Care / Q000523:psychology; D011183:Postoperative Complications; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000523:psychology; D012649:Self Concept; D011795:Surveys and Questionnaires; D013903:Thoracic Surgery; D016896:Treatment Outcome