title: Changes in cardiac and cognitive function and self-reported outcomes at one year after coronary artery bypass grafting.
abstract: OBJECTIVE
  Although health status after coronary artery bypass grafting improves at the group level, individual outcomes demonstrate variation. We aimed to evaluate relative importances of changes in cardiac and cognitive function and symptom status regarding physical and mental health at 1 year after coronary artery bypass grafting.
  
  
  METHODS
  Outcomes in multivariable regression analysis (n = 86) were self-reported physical and mental health (Medical Outcomes Study 36-Item Short Form) at 12 months' follow-up, adjusting for baseline. Independent variables were change in exercise capacity (staged ergometer protocol), cognitive function (neurocognitive test battery), and self-reported improvement of angina. Graft patency was evaluated by angiography (82/86 patients).
  
  
  RESULTS
  After surgery, health status was comparable to the age- and sex-matched population norm. Improvement of angina was associated with gain in physical health in the range of 0.5 SD (beta = 0.23, P = .012). Change in observed physical exercise capacity (mean +/- SD 199 +/- 426 W x min) accounted for 9% of variance in physical health (beta = 0.42, P = .001). Positive change in cognitive function was significantly related to mental (beta = 0.52, P = .007) but not physical health. Graft occlusion (22/82 patients) was not significantly related to health status.
  
  
  CONCLUSIONS
  Individual variation in objective functional performance and symptom relief is significant for self-reported health status, beyond the predictive ability of preoperative health status, sex, and graft patency. Awareness of the extent and impact of outcome variation is important when counseling patients before and after coronary artery bypass grafting.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway. lars.mathisen@medisin.uio.no
authors.forename: Lars
authors.initials: L
authors.lastname: Mathisen
authors.forename: Per Snorre
authors.initials: PS
authors.lastname: Lingaas
authors.forename: Marit Helen
authors.initials: MH
authors.lastname: Andersen
authors.forename: Per Kristian
authors.initials: PK
authors.lastname: Hol
authors.forename: Per Morten
authors.initials: PM
authors.lastname: Fredriksen
authors.forename: Kjetil
authors.initials: K
authors.lastname: Sundet
authors.forename: Berit
authors.initials: B
authors.lastname: Rokne
authors.forename: Astrid Klopstad
authors.initials: AK
authors.lastname: Wahl
authors.forename: Erik
authors.initials: E
authors.lastname: Fosse
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control* / Q000523:psychology; D016009:Chi-Square Distribution; D003071:Cognition; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000523:psychology; D003324:Coronary Artery Disease / Q000150:complications / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency