Health-related quality of life following coronary artery bypass graft surgery in post-menopausal women.
OBJECTIVE
To describe the impact of coronary artery bypass graft (CABG) surgery on health related quality of life (HRQOL) in post-menopausal women.


METHODS
Prospective cohort study.


METHODS
Women enrolled in the Heart and Estrogen/progestin Replacement Study (HERS).


METHODS
One hundred and thirty-seven women (mean age 66.6) who had CABG surgery while enrolled in HERS.


METHODS
Physical function was assessed using the 12-item Duke Activity Status Index (DASI), energy-fatigue with the four-item RAND scale, and mental health with the RAND mental health inventory each year. We defined baseline HRQOL from the interview that preceded the CABG (mean 4.6 months pre-CABG). To assess post-CABG HRQOL, we used the first interview that was obtained at least 6 months following the CABG (mean 11.5 months post-CABG).


RESULTS
For all three measures of HRQOL, mean scores post-CABG were virtually identical to mean scores pre-CABG (mean pre and post scores were 20.8, 20.4 for physical function, 49.3, 49.2 for energy-fatigue, and 71.9 and 72.3 for mental health). After adjusting for demographic and clinical characteristics and the expected temporal change in HRQOL, differences between pre and post-operative HRQOL remained minimal. However, on an individual patient level, there was significant variability in HRQOL outcomes. For example, while mean physical function scores changed little, 32% of women were at least moderately better (scores improved by at least 0.5 standard deviations) following surgery, while 26% were at least moderately worse (scores declined by at least 0.5 standard deviations).


CONCLUSIONS
Following CABG surgery in post-menopausal women, on average, HRQOL is virtually identical to the pre-operative baseline. However, there is significant variability, as substantial numbers of women are significantly better or significantly worse.
Covinsky
Kenneth E
KE
Division of Geriatrics, University of California, San Francisco, and San Francisco VA Medical Center (181G), San Francisco, CA 94121, USA. covinsky@medicine.ucsf.edu
Lin
Feng
F
Bittner
Vera
V
Hlatky
Mark A
MA
Knight
Sara J
SJ
Vittinghoff
Eric
E
D000368:Aged; D015331:Cohort Studies; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D017698:Postmenopause; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic