title: 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.
abstract: 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.
authors.affiliation: Department of Cardiothoracic Surgery, The Heart Center, Rigshospitalet, Copenhagen University Hospital, Section 9441, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. Birtej@rh.dk
authors.forename: Birte Østergaard
authors.initials: BØ
authors.lastname: Jensen
authors.forename: Pia
authors.initials: P
authors.lastname: Hughes
authors.forename: Lars S
authors.initials: LS
authors.lastname: Rasmussen
authors.forename: Preben U
authors.initials: PU
authors.lastname: Pedersen
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Steinbrüchel
mesh_terms: 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