Patient-reported outcome after randomization to on-pump versus off-pump coronary artery surgery.
BACKGROUND
Clinical experience with off-pump coronary artery bypass surgery raises the question of a patient experienced benefit compared with on-pump surgery. This prospective and randomized study compared patient-reported outcome between surgical groups, as change scores at 3 months after surgery and longitudinally as time-averaged change from baseline through the first year after surgery.


METHODS
In all, 120 patients were randomly assigned to on- or off-pump coronary artery surgery. A questionnaire for patient self-report of angina (Canadian Cardiovascular Society scale), health status (Short Form 36, sleep and sexual difficulty), and overall quality of life (Quality of Life Scale) was administered at baseline and at 3, 6, and 12 months after surgery.


RESULTS
Patient groups were comparable with regard to age, symptoms, comorbidity, and surgical characteristics. Both groups experienced a median of two classes relief of angina at 3 months (p < 0.0005), maintained throughout follow-up. Paired t tests revealed significant improvement on all Short Form 36 subscales at 3 months after surgery, with the exception of physical role functioning in the on-pump group. No independent main effects of surgical group were observed in the between-groups covariance models. The longitudinal effect of sex was significant in four Short Form 36 subscales: physical functioning, bodily pain, and role limitation due to physical or emotional problems. Overall quality of life scores were stable in both groups.


CONCLUSIONS
Both on-pump and off-pump patients reported less angina and improved health status after surgery. There were no significant differences between surgical groups in health status or overall quality of life, neither cross-sectionally nor longitudinally.
Mathisen
Lars
L
Department of Thoracic and Cardiovascular Surgery, Rikshospitalet University Hospital, Oslo, Norway. lars.mathisen@rikshospitalet.no
Andersen
Marit H
MH
Hol
Per K
PK
Lingaas
Per S
PS
Lundblad
Runar
R
Rein
Kjell A
KA
Tønnessen
Tor I
TI
Mørk
Bjørn E
BE
Svennevig
Jan-Ludvig
JL
Wahl
Astrid K
AK
Hanestad
Berit R
BR
Fosse
Erik
E
D000368:Aged; D001026:Coronary Artery Bypass / Q000379:methods*; D004522:Educational Status; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D010146:Pain; D011788:Quality of Life; D012890:Sleep; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome