OBJECTIVES: To document the impact of coronary artery bypass (CABG) surgery on quality of life in elderly people three months after surgery; to compare quality of life measures; to examine predictors of poor quality of life; and to assess the predictive validity of global clinical rating scales. STUDY DESIGN: Prospective cohort study with postoperative, three-month and one-year follow-up. SETTING: A 700-bed tertiary care teaching hospital in Halifax, Nova Scotia. PATIENTS: One hundred of 200 consecutive patients, 75 years and older, undergoing CABG. MEASURES: Demographic information, clinical data and global clinical ratings were collected at baseline to assess risk for adverse outcome (death, stroke, functional impairment) at each follow-up. Quality of life three months post-CABG was documented using the RAND 36-Item Health Survey and the Seattle Angina Questionnaire. MAIN RESULTS: Perioperative deaths occurred in four patients, disabling strokes in six and postoperative complications in seven. Three additional deaths occurred by the three-month follow-up and nine more by one year. On average, important improvements in quality of life were observed at three months' follow-up, using both assessments of quality of life. CONCLUSIONS: Many elderly patients do well after CABG surgery, but a higher proportion than is seen in younger patients have complications leading to death and disability. A global clinical measure by the attending cardiologist at baseline did not identify patients at a higher risk. Follow-up studies are needed to assess long term outcomes of older patients at higher risk of death or a poor quality of life after CABG surgery.
OBJECTIVES: To document the impact of coronary artery bypass (CABG) surgery on quality of life in elderly people three months after surgery; to compare quality of life measures; to examine predictors of poor quality of life; and to assess the predictive validity of global clinical rating scales. STUDY DESIGN: Prospective cohort study with postoperative, three-month and one-year follow-up. SETTING: A 700-bed tertiary care teaching hospital in Halifax, Nova Scotia. PATIENTS: One hundred of 200 consecutive patients, 75 years and older, undergoing CABG. MEASURES: Demographic information, clinical data and global clinical ratings were collected at baseline to assess risk for adverse outcome (death, stroke, functional impairment) at each follow-up. Quality of life three months post-CABG was documented using the RAND 36-Item Health Survey and the Seattle Angina Questionnaire. MAIN RESULTS: Perioperative deaths occurred in four patients, disabling strokes in six and postoperative complications in seven. Three additional deaths occurred by the three-month follow-up and nine more by one year. On average, important improvements in quality of life were observed at three months' follow-up, using both assessments of quality of life. CONCLUSIONS: Many elderly patients do well after CABG surgery, but a higher proportion than is seen in younger patients have complications leading to death and disability. A global clinical measure by the attending cardiologist at baseline did not identify patients at a higher risk. Follow-up studies are needed to assess long term outcomes of older patients at higher risk of death or a poor quality of life after CABG surgery.
Authors: Laura P Kimble; Sandra B Dunbar; William S Weintraub; Deborah B McGuire; Sharon Fazio; Anindya K De; Ora Strickland Journal: Heart Dis Date: 2002 Jul-Aug