Health-related quality of life following off-pump versus on-pump coronary artery bypass grafting in elderly moderate to high-risk patients: a randomized trial.
OBJECTIVE
Previous trials comparing coronary artery bypass grafting (CABG) with or without extracorporeal circulation have mainly enrolled selected patients at younger age and low risk. Patient-reported health-related quality of life has not been significantly different. We compared health-related quality of life in elderly moderate to high-risk patients randomized to either off-pump or on-pump surgery.


METHODS
The study is a sub-study of the randomized Best Bypass Surgery Trial that compares off-pump to on-pump treatment, with respect to peri- and postoperative mortality and morbidity in patients with a moderate to high-predicted preoperative risk. After randomization and before heart surgery, 120 consecutive patients were asked to fill in the Medical Outcomes Study Short Form 36 (SF-36) and Major Depression Inventory (MDI) diagnostic scale for self-report of health-related quality of life. Three months after surgery, the same questionnaires were mailed to the patients.


RESULTS
The response rate was 96.5%. At baseline, the groups were comparable except for a difference in educational level. Both groups improved in all eight SF-36 domains from baseline to 3 months. No statistical differences were seen between the groups except for changes in mean difference of role limitation due to emotional problems, which was significantly (P=.04) improved in favour of the on-pump group. Depression scores remained unchanged within and between the two surgical groups.


CONCLUSIONS
Both on-pump and off-pump patients improved in health-related quality of life scores after CABG surgery. No clinically relevant difference between the groups could be demonstrated.
Jensen
Birte Østergaard
BØ
Department of Cardiothoracic Surgery, The Heart Center, Rigshospitalet, Copenhagen University Hospital, Section 9441, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. Birtej@rh.dk
Hughes
Pia
P
Rasmussen
Lars S
LS
Pedersen
Preben U
PU
Steinbrüchel
Daniel A
DA
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000523:psychology / Q000534:rehabilitation*; D047549:Coronary Artery Bypass, Off-Pump / Q000523:psychology / Q000534:rehabilitation; D003863:Depression / Q000150:complications; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D016896:Treatment Outcome