title: Health-related quality of life after off-pump compared with on-pump coronary bypass grafting among elderly high-risk patients: A randomized trial with eight years of follow-up.
abstract: BACKGROUND
  Potential long-term gain in health-related quality of life (HRQoL) using off-pump coronary revascularization in elderly patients >70 years has not yet been fully elucidated.
  
  
  OBJECTIVE
  We compared HRQoL in elderly moderate- to high-risk patients 3 months, 12 months, and 8 years after randomization to either off-pump or on-pump coronary artery bypass grafting (CABG).
  
  
  METHODS
  After randomization and before heart surgery, 120 consecutive patients were asked to fill in the Medical Outcome Study Short Form 36 (SF-36) and Major Depression Inventory diagnostic scale for self-report of HRQoL. Postoperatively, the same questionnaires were mailed to the patients.
  
  
  RESULTS
  No significant difference was found in the change of SF-36 scores between the groups except in the social functioning subscale, where the 8-year score was significantly higher for the on-pump group than the off-pump group (p=0.038). In the on-pump group, all scores improved from baseline to 8 years, with the highest improvement in most of the domains after 8 years. In the off-pump group, there was an improvement in four of the eight domains from baseline to 8 years, with the highest improvement in most of the domains after 12 months. By contrast, there was a noticeable decrease in bodily pain, social functioning, and mental health at 8 years after off-pump operation. No patients showed signs of depression after 8 years.
  
  
  CONCLUSIONS
  HRQoL SF-36 scores seemed to improve more in patients undergoing on-pump CABG compared with patients undergoing off-pump surgery, although no long-term clinically relevant difference between the groups could be demonstrated.
authors: Research Unit of Nursing, Clinical Institute, University of Southern, Denmark boestergaard@health.sdu.dk.
authors: Birte
authors: B
authors: Østergaard
authors: Department of Cardiothoracic Surgery, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Denmark.
authors: Elisabeth
authors: E
authors: Holbæk
authors: Centre for Applied Health Services Research, University of Southern, Denmark.
authors: Jan
authors: J
authors: Sørensen
authors: Emergency Department, Nykøbing Falster Hospital, Denmark.
authors: Daniel
authors: D
authors: Steinbrüchel
mesh_terms: D000367:Age Factors; D000368:Aged; D047549:Coronary Artery Bypass, Off-Pump; D003324:Coronary Artery Disease / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
keywords: Coronary bypass grafting; depression; health-related quality of life; off-pump; on-pump