Changes in health-related quality of life following coronary artery bypassgraft surgery

Background. There are limited data to help clinicians identify patients lik ely to have an improvement in quality of life following CABG surgery. We ev aluated the relationship between preoperative health status and changes in quality of life following CABG surgery. Methods. We evaluated 1,744 patients enrolled in the VA Cooperative Process es, Structures, and Outcomes in Cardiac Surgery study who completed preoper ative and 6-month postoperative Short Form-36 (SF-36) surveys. The primary outcome was change in the Mental Component Summary (MCS) and Physical Compo nent Summary (PCS) scores from the SF-36. Results. On average, physical and mental health status improved following t he operation. Preoperative health status was the major determinant of chang e in quality of life following surgery, independent of anginal burden and o ther clinical characteristics. Patients with MCS scores less than 44 or PCS scores less than 38 were most likely to have an improvement in quality of life. Patients with higher preoperative scores were unlikely to have an imp rovement in quality of life. Conclusions. Patients with preoperative health status deficits are likely t o have an improvement in their quality of life following CABG surgery. Alte rnatively, patients with relatively good preoperative health status are unl ikely to have a quality of life benefit from surgery and the operation shou ld primarily be performed to (C) 2001 by The Society of Thoracic Surgeons.