Preoperative determinants of quality of life a year after coronary artery bypass grafting: a historical cohort study

Abstract

BackgroundHealth related quality of life (HRQL) is an important patient related outcome measure after cardiac surgery. Preoperative determinants for postoperative HRQL have not yet been identified, but could aid in preoperative decision making. The aim of this article is to identify associations between preoperative determinants and change in HRQL 1 year after coronary artery bypass grafting (CABG).MethodsSingle centre retrospective cohort study in 658 patients. Change in HRQL was defined as a decrease or increase of ≥5 points on the physical or mental domain of the Short Form 12 (SF-12) questionnaire. Patients were stratified in three groups according to worse, unchanged, or better HRQL. Multinomial logistic regression analysis was used to investigate the association between preoperative risk factors and postoperative change in HRQL.ResultsPhysical HRQL improved in 22.8% of patients, did not change in 61.2% of patients and worsened in 16.0% of patients. Comorbidities associated with change in physical HRQL were a history of stroke, atrial fibrillation, vascular disease or pulmonary disease. Most important risk factor for change in physical HRQL was preoperative HRQL. Higher preoperative SF-12 score decreased the odds for worse physical HRQL and increased the odds for better physical HRQL. Mental HRQL improved in 49.8% of patients, remained unchanged in 34.5% of patients and worsened in 15.7% of patients. Preoperative HRQL was an important risk factor for a change in mental HRQL. Higher preoperative physical HRQL increased the odds for improved mental HRQL. Lower preoperative mental HRQL increased the odds for better mental HRQL.ConclusionsOne year after CABG the majority of patients experiences equal or improved HRQL compared to before surgery. Most important preoperative risk factor for change in HRQL is preoperative HRQL.Electronic supplementary materialThe online version of this article (10.1186/s13019-018-0798-2) contains supplementary material, which is available to authorized users.

Assessment of the Quality of Life in Patients before and after Coronary Artery Bypass Grafting (CABG): A Prospective Study

“…Research shows that spousal social support reduces mortality and improves psychosocial recovery after surgery, as patients often rely on their partner for help before and after surgery. The comorbidities of cardiac patients are hyperlipidemia, hypertension, smoking, and diabetes [28,29], and partners give them emotional support and also help them adopt to a healthier lifestyle, reduce risk factors, or stick to their treatment through participation in a comprehensive rehabilitation program [30][31][32].…”

Impact of Cardiac Rehabilitation on Functional Capacity and Physical Activity after Coronary Revascularization: A Scientific Review

“…Alternately, a retrospective cohort observed a decline in HRQoL presenting a strong association between preoperative and postoperative scores under the physical and mental domains [10]. Following these revascularization procedures, issues of lowered aerobic capacity, levels of physical activity, and quality of life necessitated referrals to cardiac rehabilitation programs as an essential constituent for holistic treatment in patients with CVD [5,7,[10][11][12][13].…”

Physiological and Psychological Determinants of Quality of Life for Patients after Cardiac Surgery and the Associated Factors

“…The same result was supported in a study by Verwijmeren and colleagues (2018) who studied the relationship between preoperative factors and change in HRQL one year after CABG. The most important risk factor for change in the level of HRQL was the preoperative level of HRQL [7]. In contrast to a study that didn't find a significant association between pre-HRQOL and post-surgery level in patients after cardiac surgery [8].…”

“…and as a result has negative consequences on morbidity, mortality, health-related quality of life (HRQOL) [6], developing psychological and post-traumatic stress disorder (PTSD) symptoms [7].…”