title: Changes in health-related quality of life in off-pump versus on-pump cardiac surgery: Veterans Affairs Randomized On/Off Bypass trial.
abstract: BACKGROUND
  The relative benefits of performing coronary artery bypass graft surgery off-pump versus on-pump continue to be debated. A critical, patient-centered outcome is health-related quality of life; yet there has been limited evaluation in large-scale, multicenter trials of the off-pump versus on-pump impact upon quality of life.
  
  
  METHODS
  The Veterans Affairs Randomized On/Off Bypass trial randomized 2,203 nonemergent patients to off-pump or on-pump from February 2002 to May 2007. Patients completed a general quality of life survey (VR-36) and a disease-specific quality of life survey, the Seattle Angina Questionnaire (SAQ), prior to surgery, then again at 3 and 12 months post-bypass.
  
  
  RESULTS
  Of the 2,130 1-year survivors, 1,805 patients (85%) completed 1-year surveys. Randomization resulted in comparable baseline patient characteristics, including VR-36 and SAQ scores. At 3 months and 1-year post-procedure, there were no clinically relevant differences between off-pump and on-pump patients in any of the quality of life measures. Both groups had statistically significant, comparable improvements in the physical component scale of the VR-36, and in the SAQ scales.
  
  
  CONCLUSIONS
  For this trial's male, low-to-moderate risk, veteran population, there were no significant differences between off-pump and on-pump with regard to 1-year general and disease-specific quality of life outcomes. Both treatment arms experienced some improvements by 3 months, with continued improvements through 1-year post-bypass.
authors: Northport Veterans Administration Medical Center, Northport, New York, USA.
authors: Muath
authors: M
authors: Bishawi
authors: A Laurie
authors: AL
authors: Shroyer
authors: John S
authors: JS
authors: Rumsfeld
authors: John A
authors: JA
authors: Spertus
authors: Janet H
authors: JH
authors: Baltz
authors: Joseph F
authors: JF
authors: Collins
authors: Jacquelyn A
authors: JA
authors: Quin
authors: G Hossein
authors: GH
authors: Almassi
authors: Frederick L
authors: FL
authors: Grover
authors: Brack
authors: B
authors: Hattler
mesh_terms: D000368:Aged; D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000379:methods; D017023:Coronary Angiography / Q000379:methods; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods*; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects / Q000379:methods; D023903:Coronary Restenosis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D017558:Elective Surgical Procedures / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D006084:Graft Rejection; D006085:Graft Survival; D006787:Hospitals, Veterans; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D011446:Prospective Studies; D011788:Quality of Life; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome; D014481:United States