Functional status outcomes of patients with a coronary artery bypass graftover time

OBJECTIVE: To examine functional status outcomes among patients with a coro nary artery bypass graft (CABG) over time (ie, at baseline; 3 months, 6 mon ths, and 12 months after surgery) and the impact of selected patient charac teristics (ie, age, sex, comorbidities, and cardiac rehabilitation particip ation) on functional outcomes. DESIGN: A prospective, repeated-measures design was used to examine functio nal status in patients with a CABG over time. SETTING: A midwestern community hospital and regional cardiac referral cent er was the setting for enrolling patients with a CABG. OUTCOME MEASURES: Functional status outcomes were measured by using the Med ical Outcomes Study (MOS) Short Form 36 (SF-36) and Modified 7-Day Activity instruments. METHODS: Baseline data were obtained by patient interview in the hospital s etting after CABG surgery. At 3 months, 6 months, and 12 months after surge ry telephone interviews were conducted to administer research instruments. RESULTS: Baseline scores on 7 of the 8 subscales of the MOS SF-36 were sign ificantly lower than at 3 months, 6 months, or 12 months after surgery. Rol e-emotional functioning baseline scores were not significantly lower than 3 -month scores; however, baseline scores were significantly lower than 6-mon th and 12-month scores. Three-month subscale scores were also significantly lower than 6-month or 12-month scores except for the subscales measuring s ocial and general health functioning. Functional status as measured by the Modified 7-Day Activity tool did not demonstrate any significant difference s between 3 month, 6-month, or 12-month activity levels. There were no sign ificant differences by age group on any of the 8 subscales of the MOS SF-36 instrument. Women and subjects with more than I comorbidity had a signific antly lower preoperative level of physical functioning. Cardiac rehabilitat ion participants had lower preoperative scores on role-emotional functionin g than subjects who were not in rehabilitation. CONCLUSION Findings from this study can assist nurses and other health care workers to gain a perspective of the recovery and rehabilitation trajector y of patients with a CABG. The results of the study provide a basis for det ermining areas of functional limitations during recovery from CABG surgery. Study results can also be the foundation for evaluating outcomes of patien ts with a CABG when specific interventions (eg, pain management, psychosoci al support, physical strengthening, fatigue management) are implemented dur ing hospitalization, home recovery, and rehabilitation to target optimal ps ychosocial and physiologic functioning of patients with a CABG.