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Ann Thorac Surg 2001;72:2026-2032
© 2001 The Society of Thoracic Surgeons

Original article: cardiovascular

Changes in health-related quality of life following coronary artery bypass graft surgery

John S. Rumsfeld, MD, PhD*a,b, David J. Magid, MD, MPHb,c, Maureen O'Brien, PhDa, Martin McCarthy, Jr, PhDd, Samantha MaWhinney, ScDb, A. Laurie W. Shroyer, PhDa,b, Thomas E. Moritz, MSe, William G. Henderson, PhDe, Gulshan K. Sethi, MDf, Frederick L. Grover, MDa,b, Karl E. Hammermeister, MDa,b for the participants of the Department of Veterans Affairs Cooperative Study in Health Services: Processes Structures and Outcomes of Care in Cardiac Surgery

a Denver Veterans Affairs Medical Center, Denver, Colorado, USA
b Departments of Medicine and Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Denver, Colorado, USA
c Colorado Permanente Medical Group, Denver, Colorado, USA
d Department of Preventive Medicine, Northwestern University School of Medicine, Chicago, Illinois, USA
e Veterans Affairs Cooperative Studies Program Coordinating Center, Hines VA Medical Center, Hines, Illinois, USA
f Tucson Veterans Affairs Medical Center and Circulatory Sciences Program, University of Arizona Health Sciences Center, Tucson, Arizona, USA

Accepted for publication August 7, 2001.

* Address reprint requests to Dr Rumsfeld, Cardiology (111B), Denver VA Medical Center, 1055 Clermont St, Denver, CO 80220, USA
e-mail: john.rumsfeld{at}med.va.gov

Background. There are limited data to help clinicians identify patients likely to have an improvement in quality of life following CABG surgery. We evaluated the relationship between preoperative health status and changes in quality of life following CABG surgery.

Methods. We evaluated 1,744 patients enrolled in the VA Cooperative Processes, Structures, and Outcomes in Cardiac Surgery study who completed preoperative and 6-month postoperative Short Form-36 (SF-36) surveys. The primary outcome was change in the Mental Component Summary (MCS) and Physical Component Summary (PCS) scores from the SF-36.

Results. On average, physical and mental health status improved following the operation. Preoperative health status was the major determinant of change in quality of life following surgery, independent of anginal burden and other clinical characteristics. Patients with MCS scores less than 44 or PCS scores less than 38 were most likely to have an improvement in quality of life. Patients with higher preoperative scores were unlikely to have an improvement in quality of life.

Conclusions. Patients with preoperative health status deficits are likely to have an improvement in their quality of life following CABG surgery. Alternatively, patients with relatively good preoperative health status are unlikely to have a quality of life benefit from surgery and the operation should primarily be performed to improve survival.




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