Health-related quality of life as a predictor of mortality following coronary artery bypass graft surgery

Context Health-related quality of life has not been evaluated as a predicto r of mortality following coronary artery bypass graft (CABG) surgery. Evalu ation of health status as a mortality predictor may be useful for preoperat ive risk stratification. Objective To determine whether the Physical and Mental Component Summary sc ores from the preoperative Short-Form 36 (SF-36) health status survey predi ct mortality following CABG surgery after adjustment for known clinical ris k variables. Design Prospective cohort study conducted between September 1992 and Decemb er. 1996. Setting Fourteen Veterans Affairs hospitals. Patients Of the 3956 patients undergoing CABG surgery only and who were enr olled in the Processes, Structures, and Outcomes of Care in Cardiac Surgery study, the 2480 who completed a preoperative SF-36. Main Outcome Measure All-cause mortality within 180 days after surgery. Results A total of 117 deaths (4.7%) occurred within 180 days of CABG surge ry. The Physical Component Summary of the preoperative SF-36 was a statisti cally significant risk factor for 6-month mortality after adjustment for kn own clinical risk factors for mortality following CABG surgery. In multivar iate analysis, a 10-point lower SF-36 Physical Component Summary score had an odds ratio (OR) of 1.39 (95% confidence interval [CI], 1.11-1.77; P = .0 06) for predicting mortality. The SF-36 Mental Component Summary score was not associated with 6-month mortality in multivariate analyses (OR, 1.09; 9 5% CI, 0.92-1.29; P = .31). Conclusions The Physical Component Summary score from the preoperative SF-3 6 is an independent risk factor for mortality following CABG surgery. The b aseline Mental Component Summary score does not appear to be predictive of mortality. Preoperative patient: self-report of the physical component of h ealth status may be helpful for risk stratification and clinical decision m aking for patients undergoing CABG surgery.