Outcomes of coronary artery bypass surgery in elderly people

OBJECTIVES: To document the impact of coronary artery bypass (CABG) surgery on quality of life in elderly people three months after surgery; to compar e 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 Scoria. PATIENTS: One hundred of 200 consecutive patients, 75 years and older, unde rgoing CABG. MEASURES: Demographic information, clinical data and global clinical rating s were collected at baseline to assess risk for adverse outcome (death, str oke, functional impairment) at each follow-up. Quality of life three months post-CABG was documented using the RAND 36-Item Health Survey and the Seat tle Angina Questionnaire. MAIN RESULTS: Perioperative deaths occurred in four patients, disabling str okes in six and postoperative complications in seven. Three additional deat hs occurred by the three-month follow up and nine more by one year. On aver age, important improvements in quality of life were observed at three month s' 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 cardiologi st at baseline did not identify patients at a higher risk. Follow-up studie s are needed to assess long term outcomes of older patients at higher risk of death or a poor quality of life after CABG surgery.