Quality of life 12 months after coronary artery bypass graft surgery

OBJECTIVE: The primary purpose of this study was to assess the relationship between preoperative risk factors, postoperative chronic pain, sleep, and gender on perceptions of quality of life (QoL) in a sample of 123 coronary artery bypass graft (CABG) surgery patients 12 months after surgery. A seco ndary purpose was to determine whether there is concordance between spousal and patient reporting of QoL after CABG surgery. DESIGN: A cross-sectional comparative study. SETTING: The study setting included patients living in the community, who h ad had CABG surgery 12 months earlier at The Alfred hospital, a major metro politan public acute care center, in Melbourne, Australia. PARTICIPANTS: Study participants were 123 adult patients (mean age = 64 yea rs) who had undergone CABG surgery and had participated in a recent clinica l trial. These patients were followed up to 12 months. The patient's spouse or next of kin (NoK) was asked questions about their perception of I chang e in the patient's QoL. INSTRUMENTS: Results were assessed using The Medical Outcome Study Short Fo rm-36 (SF-36) questionnaire and additional questions given at 12 months aft er CABG surgery. The Cleveland Clinic Clinical Severity Score (CSS) was use d preoperatively as a tool to predict QoL outcome. RESULTS: Significant improvements in QoL, as measured by the SF-36, were se en in physical functioning (P < .0001), bodily pain (P = .024), social func tioning (P = .011), and role limitations resulting from emotional status (P = .003). Other significant associations (P = .002) were found between poor QoL and patients who reported severe pain or poor quality sleep. Low-risk patients, as identified by the preoperative CSS, were more likely to have i mproved QoL at 12 months. Alteration in QoL was reported equally by patient s and their spouses or NoK. Short term memory impairment was reported by 41 .% of spouses or NoK. CONCLUSIONS: CABG surgery results in improved QoL for the majority of patie nts with extensive coronary artery disease. Nevertheless, some patients con tinue to have severe pain, sleep disturbances, and altered relationship wit h their spouse or NoK 12 months after surgery.