title: Gender differences in health-related quality of life after coronary bypass surgery: results from a 1-year follow-up in propensity-matched men and women.
abstract: OBJECTIVE
  To examine whether the predictive value of gender for health-related quality of life (HRQoL) is independent of clinical health status and depression. Women undergoing coronary bypass surgery generally report a poorer HRQoL than men.
  
  
  METHODS
  A total of 990 (20% women) patients completed study questionnaires 1 day before coronary bypass surgery and 1 year after surgery. Physical aspects of HRQoL were assessed with the Short Form 36 Health Survey. Depression was measured with the self-reported Patient Health Questionnaire. Propensity score matching was applied to match men and women with respect to 65 clinical variables. Of 198 women, 157 (79.3%) could be matched to a partner, resulting in an excellent balance of clinical variables between the matched groups.
  
  
  RESULTS
  At baseline, propensity-matched men and women differed in physical functioning (p < .001) and role functioning (p = .007), but not in bodily pain and general health perception. In both men and women, HRQoL outcomes improved over 1 year. Preoperative depression predicted worse physical HRQoL in all outcomes, except general health perception 1 year after surgery. After adjusting for depression, gender lost its predictive power with respect to physical functioning. However, compared with women, men still reported a better role functioning.
  
  
  CONCLUSIONS
  Our data suggest that gender is a marker for role functioning, independent of the clinical health status and depression. Rehabilitation measures designed for the specific needs of women might help to improve their HRQoL.
authors.affiliation: Institut für Medizinische Psychologie, Charité Centrum 1 für Human- und Gesundheitswissenschaften, Charité-Universitätsmedizin Berlin, Luisenstraße 57, 10117 Berlin, Germany. friederike.kendel@charite.de
authors.forename: Friederike
authors.initials: F
authors.lastname: Kendel
authors.forename: Anne
authors.initials: A
authors.lastname: Dunkel
authors.forename: Thomas
authors.initials: T
authors.lastname: Müller-Tasch
authors.forename: Kerstin
authors.initials: K
authors.lastname: Steinberg
authors.forename: Elke
authors.initials: E
authors.lastname: Lehmkuhl
authors.forename: Roland
authors.initials: R
authors.lastname: Hetzer
authors.forename: Vera
authors.initials: V
authors.lastname: Regitz-Zagrosek
mesh_terms: D000368:Aged; D001294:Attitude to Health; D003289:Convalescence / Q000523:psychology; D001026:Coronary Artery Bypass / Q000523:psychology*; D003327:Coronary Disease / Q000601:surgery; D003863:Depression / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008571:Men / Q000523:psychology*; D011379:Prognosis; D057216:Propensity Score; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014930:Women / Q000523:psychology*