title: Quality of life in young, professionally active men undergoing on-pump coronary artery bypass grafting--short-term follow-up results.
abstract: BACKGROUND
  The impact of coronary artery bypass grafting (CABG) on the quality of life (QoL) is one of the important measures of the efficacy of the procedure. This issue in young, professionally active male patients has not been extensively studied.
  
  
  OBJECTIVE
  To assess QoL before and after on-pump CABG, and before and after cardiac rehabilitation in young men with low operative risk.
  
  
  METHODS
  The study group comprised 50 men aged 54.4 +/- 5.6 years who were professionally active before the surgery. The QoL was assessed on the basis of the MacNew questionnaire (in points). We analysed QoL changes and effects of basic demographic and peri-operative data on QoL during a short-term follow-up.
  
  
  RESULTS
  All components of QoL deteriorated shortly after CABG: emotional - from 4.97 +/- 0.96 to 4.66 +/- 1.0 (p = 0.03); physical - from 4.49 +/- 1.1 to 4.2 +/- 1.2 (p = 0.02); and social - from 4.68 +/- 1.0 to 4.47 +/- 1.1 (p = 0.1). Pre-operative physical and social QoL positively correlated with age (r = 0.45 and r = 0.37, respectively) and left ventricular ejection fraction (LVEF) (r = 0.49 and r = 0.48, respectively). However, there was a negative impact of history of myocardial infarction on physical QoL (p < 0.05). A negative influence of cardiopulmonary bypass time (r = -0.45) and cross-aortic clamp time (r = -0.36) on physical QoL was also noted. The QoL values were also influenced by class of angina symptoms (R = -0.33 / -0.42), total drainage (r = -0.11 / -0.34) and quantity of grafts (R = -0.35 / -0.42). During rehabilitation, QoL significantly improved: emotional - from 5.29 +/- 0.92 to 5.96 +/- 0.9 (p = 0.01); physical - from 4.66 +/- 1.1 to 5.42 +/- 1.2 (p < 0.01); and social - from 4.69 +/- 1.2 to 5.65 +/- 1.1 (p < 0.01). The QoL during rehabilitation was correlated with baseline peri-operative risk (for logistic EuroSCORE algorithm r = -0.21 / -0.31 and for EuroSCORE R = -0.47 / -0.89). Significant determinants of some components of QoL were also LVEF (r= 0.26 / 0.47), morphological blood parameters (r = 0.37 / 0.43), baseline CCS class (R = 0.31 / 0.58), age (r = -0.41 / -0.83), and extent of surgery defined by cardiopulmonary bypass time, cross-aortic clamp duration and total drainage.
  
  
  CONCLUSIONS
  Quality of life in young, professionally active men significantly deteriorates a few days after on-pump CABG but systematically improves during the next weeks, particularly after rehabilitation. Pre-operative QoL correlates positively with age and LVEF, and negatively with a history of myocardial infarction. Age, pre-operative risk, angina symptoms and the extent of surgery have negative effects on physical QoL after CABG during short-term observation.
authors.affiliation: Silesian Medical University, Katowice, Poland. l.krzych@wp.pl
authors.forename: Lukasz J
authors.initials: LJ
authors.lastname: Krzych
authors.forename: Anna
authors.initials: A
authors.lastname: Woźnica
authors.forename: Adam
authors.initials: A
authors.lastname: Pawlak
authors.forename: Janusz
authors.initials: J
authors.lastname: Skarysz
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Eysymontt
authors.forename: Beata
authors.initials: B
authors.lastname: Chromańska-Matera
authors.forename: Irena
authors.initials: I
authors.lastname: Krupka-Matuszczyk
authors.forename: Andrzej
authors.initials: A
authors.lastname: Bochenek
authors.forename: Marek
authors.initials: M
authors.lastname: Cisowski
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000367:Age Factors; D001026:Coronary Artery Bypass / Q000523:psychology* / Q000534:rehabilitation*; D005500:Follow-Up Studies; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000523:psychology / Q000628:therapy; D011044:Poland; D011184:Postoperative Period; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D012944:Social Support; D011795:Surveys and Questionnaires; D016896:Treatment Outcome