QUALITY-OF-LIFE, BYPASS-SURGERY AND THE ELDERLY

OBJECTIVE: To examine changes in health-related quality of life (HQOL) following coronary artery bypass surgery (CABS) in elderly patients a nd to compare patient ratings with proxy ratings. DESIGN: Descriptive, nonrandomized, prospective study. SETTING: Patients from a single pri mary care facility in a major urban centre within alone year period. P ATIENTS: All eligible patients undergoing CABS at the site within a on e-year period were approached for study participation. The study sampl e consisted of 18 patients 65 years of age or older and 18 proxies at baseline. Fourteen patients and 13 proxies completed follow-up assessm ents. INTERVENTIONS: All patients underwent CABS. HQOL was studied usi ng the Sickness Impact Profile (SIP) and the Psychological Well-Being Schedule (PGWB). MAIN RESULTS: Significant improvements were noted in physical, social and psychological functioning (P less than or equal t o 0.05). Proxies' reports provided good indications of patient functio ning for these dimensions with significant differences found only for certain preoperative measures including the total SIP score and the An xiety and Depression subscales of the PGWB (P less than or equal to 0. 05). CONCLUSIONS: Patients 65 years of age and older accrue improvemen ts in HQOL following CABS. Such findings may influence the allocation and justification of various medical procedures. Proxy ratings closely reflected the patients' own ratings and may therefore be considered a reliable, alternate source of information.