Comparison of Outcome in Male and Female Indian Patients Undergoing Cabg, Activity Levels and Quality of Life: One Year Follow-Up Study

Abstract

Abstract:This study intended to find out the outcome (in terms of quality of life and activity levels) of coronary artery bypass graft surgery (CABG) in Indian population; and whether there are differences associated with gender of the patient. Standard SF 36 questionnaire was utilized to access patient's general health, emotional status, and social activity following surgery. It has been noted that, there is significant apprehension amongst Indian population related to open heart surgery and that patients are hesitant to return back to their normal preoperative routine following heart surgery especially CABG. The socioeconomic and educational background of the Indian patient population is commonly such that it precludes them from returning to full activity status following surgery. Hence this study is conceptualized to objectivise the outcome following CABG surgery in Indian patients and also assess any gender differences noted in the outcome following this surgery. Material and Methods: Prospective analysis was done at one year follow up of patients undergoing coronary artery bypass grafting between 1 st July 2015 -31 st October 2016, without having other cardiac complications like mitral regurgitation, ventricular dysfunction, ventricular aneurysm/rupture or other complications. Patients who were operated on pump/off pump, having preop diabetes or hypertension at AIIMS New Delhi, coming for follow up at routine intervals, were included in this study. Using SF 36 questionnaire here we recorded the patients' detailed activity levels and quality of life in post-operative period, also we correlated the impact of CABG surgery with gender of patients. We compared the outcome in 168 male and female patients, who underwent CABG surgery during the study period. Follow-up was completed at intervals of 1 week, 1 month, 3 months, 6 months and 12 months following surgery. This follow-up was done both telephonically and during their office visits. Results: After 4 weeks following CABG (average 30 days), both men and women had less anxiety and symptoms related to depression than before surgery. After 6 months (average 184 days), both men and women improved in their physical and social functioning. Although changes in scale scores were similar for men and women at each time point, women scored lower than men on these domains, and had more symptoms related to depression through 1 year after CABG. Conclusions: Both male and female patients improve in physical, social, and emotional functioning after CABG, and recovery over time is similar in men and women. However women's health-related quality-of-life scale scores remained less favourable than men's through 1 year after surgery.

Gender bias in cardiovascular disease prevention, detection, and management, with specific reference to coronary artery disease

“…However, women's health-related quality-of-life scale scores remained less favorable than men's through 1 year after surgery. [ 45 ]…”

Quality of life and activities of daily living one year after Coronary Artery Bypass Graft (CABG) surgery: a cross-sectional study

“…Find in this case, we can refer to the findings of Benunotti et al in their study, they found that the functional capacity of patients is still low three months and one year after coronary artery bypass surgery [10,11]. This is despite the fact that some studies have reported that the ability of these patients to take care of themselves after surgery is favorable [11,12].…”

“…In this study, the psychometrically validated Persian form of this tool was used [26]. This questionnaire includes 12 questions that assess the patient's quality of life in terms of general understanding of their health (question 1), physical performance (questions 2, 3), physical health (questions 4, 5), physical problems (questions 6, 7), examines physical pain (question 8), social function (question 9), vitality and vital energy (question 10) and mental health (question 11,12). The total score of the questionnaire is calculated and obtained from the sum of the scores related to 12 questions.…”

“…The range of scores of this questionnaire varies from 12 to 48. According to the scores they get in the questionnaire, people are classified into three categories: poor (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24), average (25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36), and good (37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48). Therefore, earning more points means a better quality of life.…”