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Ann Thorac Surg 2004;77:1508-1513
© 2004 The Society of Thoracic Surgeons

Original article: cardiovascular

Predictors of health-related quality of life after coronary artery bypass surgery

John S. Rumsfeld, MD, PhDa*, P. Michael Ho, MDa, David J. Magid, MD, MPHb,c, Martin McCarthy, Jr, PhDd, A. Laurie W. Shroyer, PhDa, Samantha MaWhinney, ScDb, Frederick L. Grover, MDe, Karl E. Hammermeister, MDa

a Cardiology and Health Services Research, Denver VA Medical Center, University of Colorado Health Sciences Center, Denver, Colorado, USA
b Colorado Permanente Medical Group, Denver, Colorado, USA
c Department of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Denver, Colorado, USA
d Department of Preventive Medicine, Northwestern University School of Medicine, Chicago, Illinois, USA
e Department of Surgery, University of Colorado Health Sciences Center, Denver, Colorado, USA

Accepted for publication October 8, 2003.

* 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: Little is known about the determinants of health-related quality of life after coronary artery bypass surgery. We determined the predictors of overall physical and mental health status 6 months after the operation.

METHODS: We evaluated 1,973 patients enrolled in a multicenter Veterans Affairs prospective cohort study who completed preoperative and 6-month postoperative Short Form-36 (SF-36) health status surveys. Multiple linear regression was used to identify the significant independent predictors of 6-month physical and mental component summary scores from the SF-36.

RESULTS: In multivariable analyses adjusting for baseline health status, significant predictors of postoperative physical health status were a history of neurologic disease, peripheral vascular disease, chronic obstructive pulmonary disease, hypertension, current smoking, forced expiratory volume, left ventricular ejection fraction, and serum creatinine. Significant predictors of postoperative mental health status were a history of psychiatric disease, chronic obstructive pulmonary disease, current smoking, age, and New York Heart Association functional class.

CONCLUSIONS: These predictors of health-related quality of life after coronary artery bypass surgery may be useful for preoperative risk assessment and counseling of patients with regard to anticipated health status outcomes. Factors such as current smoking and psychiatric disease may be targets for interventions to improve health-related quality of life outcomes.




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