Health-related Quality of Life Following Coronary Artery Bypass Graft Surgery in Post-menopausal Wom
June 27th, 2008 | by admin |Health-related Quality of Life Following Coronary Artery Bypass Graft Surgery in Post-menopausal Women.
OBJECTIVES: To describe the impact of coronary artery bypass graft (CABG) surgery on health related quality of life (HRQOL) in post-menopausal women. DESIGN: Prospective cohort study. SETTING: Women enrolled in the Heart and Estrogen/progestin Replacement Study (HERS). PARTICIPANTS: One hundred and thirty-seven women (mean age 66.6) who had CABG surgery while enrolled in HERS. MEASUREMENTS: Physical function was assessed using the 12-item Duke Activity Status Index (DASI), energy-fatigue with the four-item RAND scale, and mental health with the RAND mental health inventory each year. We defined baseline HRQOL from the interview that preceded the CABG (mean 4.6 months pre-CABG). To assess post-CABG HRQOL, we used the first interview that was obtained at least 6 months following the CABG (mean 11.5 months post-CABG). RESULTS: For all three measures of HRQOL, mean scores post-CABG were virtually identical to mean scores pre-CABG (mean pre and post scores were 20.8, 20.4 for physical function, 49.3, 49.2 for energy-fatigue, and 71.9 and 72.3 for mental health). After adjusting for demographic and clinical characteristics and the expected temporal change in HRQOL, differences between pre and post-operative HRQOL remained minimal. However, on an individual patient level, there was significant variability in HRQOL outcomes. For example, while mean physical function scores changed little, 32% of women were at least moderately better (scores improved by at least 0.5 standard deviations) following surgery, while 26% were at least moderately worse (scores declined by at least 0.5 standard deviations). CONCLUSION: Following CABG surgery in post-menopausal women, on average, HRQOL is virtually identical to the pre-operative baseline. However, there is significant variability, as substantial numbers of women are significantly better or significantly worse.
Covinsky KE, Lin F, Bittner V, Hlatky MA, Knight SJ, Vittinghoff E.
Division of Geriatrics, University of California, San Francisco, and San Francisco VA Medical Center (181G), San Francisco, CA, USA, covinsky@medicine.ucsf.edu.