title: Patient characteristics can predict improvement in functional health after elective coronary artery bypass grafting.
abstract: BACKGROUND
  Despite many patients undergoing coronary artery bypass grafting (CABG) to improve their functional status, literature in this area is limited. The purpose of this study is to determine the effect of CABG on the functional health of an elective population and to identify preoperative patient characteristics associated with improved functional health after surgery.
  
  
  METHODS
  Physical and mental functional health was assessed before and 6 months after surgery with the Short-Form Health Survey (SF-36) in 1,061 consecutive patients undergoing elective, isolated CABG. Survey data were complete in 529 patients (49.9%). Preoperative information on patient demographics, severity of cardiovascular illness, and disease comorbidities was also prospectively collected.
  
  
  RESULTS
  Six months post-CABG the mean summary score for physical function improved by 31.9% over baseline (45.1 versus 34.2, p < 0.0001). The mean summary score for mental function improved by 7.3% over baseline (51.3 versus 47.8, p < 0.0001). Overall 73.2% of patients showed improvement in physical function and 41.6% showed improvement in mental function. Multivariate logistic regression identified certain preoperative characteristics as negative correlates of a significant improvement in physical functioning: body mass index 35 kg/m2 or greater, diabetes with sequelae, chronic obstructive pulmonary disease, peripheral vascular disease, and baseline physical function. Baseline mental function and chronic obstructive pulmonary disease were identified as negative correlates and older age as a positive correlate of significant improvement in mental functioning.
  
  
  CONCLUSIONS
  Patient characteristics exist that impact functional health after elective CABG. Knowledge of these characteristics may be helpful when counseling patients about expected improvement in functional health with CABG.
authors.affiliation: Division of Cardiothoracic Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242, USA. karl-welke@uiowa.edu
authors.forename: Karl F
authors.initials: KF
authors.lastname: Welke
authors.forename: Jennifer P
authors.initials: JP
authors.lastname: Stevens
authors.forename: William C
authors.initials: WC
authors.lastname: Schults
authors.forename: Eugene C
authors.initials: EC
authors.lastname: Nelson
authors.forename: Virginia L
authors.initials: VL
authors.lastname: Beggs
authors.forename: William C
authors.initials: WC
authors.lastname: Nugent
mesh_terms: D000203:Activities of Daily Living / Q000145:classification*; D000368:Aged; D015897:Comorbidity; D001026:Coronary Artery Bypass / Q000523:psychology; D003327:Coronary Disease / Q000523:psychology / Q000601:surgery*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology* / Q000523:psychology; D011446:Prospective Studies; D011788:Quality of Life; D012803:Sick Role