Optimism and rehospitalization after coronary artery bypass graft surgery

Objective: To determine whether optimism predicts lower rates of rehospital ization after coronary artery bypass graft surgery for the 6 months after s urgery. Methods: A prospective, inception cohort design was used. The sample consis ted of all consenting patients (N = 309) from a consecutive series of patie nts scheduled for elective coronary artery bypass graft surgery at a large, metropolitan hospital in Pittsburgh, Pa. To be eligible, patients could no t be scheduled for any other coincidental surgery (eg, valve replacement) a nd could not be in the cardiac intensive care unit or experiencing angina a t the time of the referral. Participants were predominantly men (69.9%) and married (80.3%), and averaged 62.8 years of age. Recruitment occurred betw een January 1992 and January 1994. Results Compared with pessimistic persons, optimistic persons were signific antly less likely to be rehospitalized for a broad range of aggregated prob lems (including postsurgical sternal wound infection, angina, myocardial in farction, and the need for another bypass surgery or percutaneous translumi nal coronary angioplasty) generally indicative of a poor response to the in itial surgery (odds ratio = 0.50, 95% confidence interval = 0.33-0.76; P = .001). The effect of optimism was independent of traditional sociodemograph ic and medical control variables, as well as independent of the effects of self-esteem, depression, and neuroticism. All-cause rehospitalization also tended to be less frequent for optimistic than for pessimistic persons (odd s ratio = 0.77, 95% confidence interval = 0.57-1.05; P = .07). Conclusions: Optimism predicts a lower rate of rehospitalization after coro nary artery bypass graft surgery. Fostering positive expectations may promo te better recovery.