Changes in health-related quality of life following coronary artery bypass graft surgery.
BACKGROUND
There are limited data to help clinicians identify patients likely to have an improvement in quality of life following CABG surgery. We evaluated the relationship between preoperative health status and changes in quality of life following CABG surgery.


METHODS
We evaluated 1,744 patients enrolled in the VA Cooperative Processes, Structures, and Outcomes in Cardiac Surgery study who completed preoperative and 6-month postoperative Short Form-36 (SF-36) surveys. The primary outcome was change in the Mental Component Summary (MCS) and Physical Component Summary (PCS) scores from the SF-36.


RESULTS
On average, physical and mental health status improved following the operation. Preoperative health status was the major determinant of change in quality of life following surgery, independent of anginal burden and other clinical characteristics. Patients with MCS scores less than 44 or PCS scores less than 38 were most likely to have an improvement in quality of life. Patients with higher preoperative scores were unlikely to have an improvement in quality of life.


CONCLUSIONS
Patients with preoperative health status deficits are likely to have an improvement in their quality of life following CABG surgery. Alternatively, patients with relatively good preoperative health status are unlikely to have a quality of life benefit from surgery and the operation should primarily be performed to improve survival.
Rumsfeld
J S
JS
Denver Veterans Affairs Medical Center, Colorado 80220, USA. john.rumsfeld@med.va.gov
Magid
D J
DJ
O'Brien
M
M
McCarthy
M
M
MaWhinney
S
S
Scd
Shroyer
A L
AL
Moritz
T E
TE
Henderson
W G
WG
Sethi
G K
GK
Grover
F L
FL
Hammermeister
K E
KE
D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D000787:Angina Pectoris / Q000523:psychology / Q000601:surgery*; D001026:Coronary Artery Bypass / Q000523:psychology*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000523:psychology*; D011788:Quality of Life; D012803:Sick Role; D016896:Treatment Outcome