Time related quality of life after elective cardiac operation

Background. Due to improved operative techniques, myocardial preservation, and perioperative care, open heart procedures are now being performed in ol der and sicker patients. As a result, the quality of life has become an imp ortant issue in the decision making process. Methods. Between January 1993 and October 1994, 604 patients above 65 years of age who underwent nonemergent open heart operations were followed prosp ectively over a 2-year period. The Health Status Questionnaire forms were d istributed to all patients preoperatively and to hospital survivors at 3, 1 2, and 24 months. The questionnaire contains 36 questions and is divided in to eight categories. Follow-up was 100% complete with 99.6% of questionnair es returned. Results. Significant quality of life improvements were noted in all categor ies after surgery. After reaching a peak at 12 months, there were small, bu t significant declines in scores relating to physical health and health per ception at 24 months. In contrast, measurements for mental attributes conti nued to increase with time. By multivariate analysis, diabetes, older age, and female gender had a relatively adverse influence on quality of life des pite improvement after operation. Similarly, patients with chronic obstruct ive pulmonary disease or having redo operations had lower health perception with some physical limitations. While procedure type (coronary artery bypa ss grafting) was associated with preoperative bodily pain, congestive heart failure symptoms were not an independent factor affecting quality of life. Conclusions. Quality of life improves with cardiac surgical interventions i n this studied age group and should not be denied even in the elderly popul ation. (C) 1999 by The Society of Thoracic Surgeons.