PREDICTING COMPLETENESS OF SYMPTOM RELIEF AFTER MAJOR HEART-SURGERY

The authors hypothesized that the same biopsychosocial factors that ra ise the risk of illness incidence would influence the speed and comple teness of relief from physical symptoms during recovery following card iac surgery. This multicenter prospective study involved 463 patients aged 35 to 69 years who underwent coronary artery bypass graft or card iac valve surgery. Predictor data were gathered 1 to 3 days before sur gery, and outcome measures were collected 6 months postoperatively. Th e following predictors were associated with postoperative freedom from cardiac symptoms: fewer preoperative cardiac hospitalizations; low le vels of angina, dyspnea, fatigue, and sleep problems; low levels of an xiety, depression, hostility, and life-change events; and high levels of psychosocial well-being, hopefulness, overall satisfaction, and soc ial support. The predictors of not requiring daytime bed rest because of cardiac symptoms during the 6th postoperative month were male gende r higher education, less cardiac disability preoperatively, low levels of angina, dyspnea, sleep problems, depression and fatigue, and absen ce of Type A behavior and of intraoperative hypotension. By using sepa rate multiple logistic regression equations, the authors identified th e variables printed in bold face as independent significant contributo rs to prediction. Many of the predictors are strong enough and simple enough to be used in clinical practice. Many of them may also pr-edict recovery after acute illnesses and injuries involving other organ sys tems.