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.
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.
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.
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.