Effect of Functional Health-Related Quality of Life on Long-Term Survival After Cardiac Surgery

Neuropsychologic and quality-of-life outcomes after coronary artery bypass surgery with and without cardiopulmonary bypass: a prospective randomized trial

OBJECTIVES

The objective of this study was to compare neuropsychologic and quality-of-life outcomes of patients undergoing off-pump coronary artery bypass surgery to those undergoing coronary artery bypass graft surgery using conventional cardiopulmonary bypass.

DESIGN

A prospective randomized trial of coronary artery bypass graft surgery with and without the use of cardiopulmonary bypass.

SETTING

A cardiothoracic surgery unit at a tertiary hospital.

PARTICIPANTS

Sixty-six patients undergoing coronary artery bypass graft surgery and a control group of 50 participants not undergoing cardiac surgery.

INTERVENTIONS

Patients were randomized to receive coronary artery bypass graft surgery with cardiopulmonary bypass or randomized to coronary artery bypass graft surgery without the use of cardiopulmonary bypass.

MEASUREMENTS AND MAIN RESULTS

The proportions of neuropsychologic deficits and improvement in quality-of-life were comparable regardless of whether patients were randomized to receive off-pump coronary artery bypass graft surgery or conventional coronary artery graft surgery with cardiopulmonary bypass.

CONCLUSIONS

Patients receiving coronary artery bypass grafts without cardiopulmonary bypass did not show fewer cognitive deficits or greater improvement in quality of life.

Patient and spouse perceived quality of life five years after coronary artery bypass graft surgery

Health-related quality of life (HRQoL) was examined in patients’ and their respective spouses’ perspectives five years after cardiac bypass surgery. Participants completed the Short-Form 36 (SF-36) which consists of eight domains and two component summary scores measuring physical and mental HRQoL (PCS and MCS respectively). Paired t tests were used to compare couples responses (n=56 pairs) with spouses recording higher (i.e. better scores) in the physical-related domains although differences were not significant. Statistically significant results were found between patients and spouses in emotional role, mental health, social functioning, energy/vitality and general health perceptions (p< 0.001). The PCS were very similar for both the patient and spouses sample (45.9 v. 45.8 respectively, p = .829) and the MCS was significantly higher in the patients compared to the spouses (54.8 v. 47.7, p < .001). The results demonstrated that spouses could accurately report the physical aspects of HRQoL but not the mental health of their partner.

Quality of life and behavioral compliance in cardiac rehabilitation patients: a longitudinal survey

BACKGROUND

Few data regarding inter-relations between health-related quality of life (HRQoL) and compliance are available. The aim of present study was to assess which aspects of HRQoL might predict patients' behavioral compliance to medical suggestions and whether questionnaires might be useful for patients undergoing cardiac rehabilitation.

METHODS

HRQoL and compliance were measured in 52 consecutive patients undergoing cardiovascular rehabilitation. The measurements were performed at the beginning, at the end of rehabilitation, and after 6 months follow-up. Baseline, demographic and HRQoL characteristics were linked to compliance by multiple regression modelling.

RESULTS

Over time no significant differences between HRQoL and compliance scores were observed. Age (odds ratio (OR) 1.37, 95% confidence interval (CI) 1.08-2.45), number of taken drugs (OR=1.45; 95% CI: 1.02-2.11), anxiety score (OR=0.32; 95% CI: 0.15-1.02), depression score (OR=0.48; 95% CI: 0.06-0.78), and social health score (OR=1.09; 95% CI: 1.01-1.24), appeared to be independent predictors of compliance.

CONCLUSION

Older age, higher number of drugs, high social health score, and low anxiety and depression scores predict better behavioral compliance in cardiac rehabilitation patients.