Journal Article

A 12-year follow-up on the changes in health-related quality of life after coronary artery bypass graft surgery

Matti Hokkanen, Otso Järvinen, Heini Huhtala and Matti R. Tarkka

in European Journal of Cardio-Thoracic Surgery

Published on behalf of European Association for Cardio-Thoracic Surgery

Volume 45, issue 2, pages 329-334
Published in print February 2014 | ISSN: 1010-7940
Published online July 2013 | e-ISSN: 1873-734X | DOI: http://dx.doi.org/10.1093/ejcts/ezt358
A 12-year follow-up on the changes in health-related quality of life after coronary artery bypass graft surgery

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  • Cardiovascular Medicine
  • Cardiothoracic Surgery

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OBJECTIVES

Improvement in quality of life (QoL) and survival benefit are the primary objectives of coronary artery bypass graft (CABG) surgery. The profile of patients undergoing isolated CABG has altered towards higher age with more preoperative comorbidities. Thus, the importance of QoL over the quantity of life among elderly patients is getting more emphasized. In this study, our main goal was to evaluate the long-term changes in QoL, overall performance status and symptomatic status after the CABG.

METHODS

Comprehensive data of 508 patients who underwent isolated CABG in a single institution were prospectively collected. The RAND-36 Health Survey (RAND-36) was used as an indicator of QoL. Karnofsky dependency category was used to evaluate overall performance status, and symptomatic status was assessed using New York Heart Association (NYHA) class. All assessment were made preoperatively and repeated 1 year and 12 years later. The follow-up of the study cohort was complete in 95 and 84% of the alive patients at 1 year and 12 years, respectively. Analysis was based mainly on three age groups: ≤64 years (282 patients), 65–74 years (175 patients) and ≥75 years (51 patients).

RESULTS

Thirty-day, 1-year and 10-year survival rates were 98, 97 and 79%, respectively. Twelve years after the surgery significant improvement (P < 0.05) was seen in all but one RAND-36 dimensions of the QoL (general health, P = 0.76) as well as in functional capacity (P < 0.001) and NYHA class. All age groups showed improvements in RAND-36 physical component summary (PCS) and mental component summary (MCS) scores compared with the preoperative values. The youngest subgroup maintained their physical and mental health status best, whereas older subgroups had more pronounced decreases in their PCS and MCS scores.

CONCLUSIONS

Despite an ongoing deterioration 12 years after the CABG, there was significant improvement in most dimensions of the QoL and functional capacity in comparison with the preoperative values. The elderly gain less long-term benefit from CABG regarding the QoL and survival.

Keywords: Coronary artery bypass; Outcomes; Quality of life; Functional capacity; Elderly

Journal Article.  3268 words.  Illustrated.

Subjects: Cardiovascular Medicine ; Cardiothoracic Surgery

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