Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2011, vol. 20, nr 4, July-August, p. 447–453

Publication type: original article

Language: English

Short-Term Improvement of Patients’ Quality of Life After Coronary Artery Bypass Grafting – a Prospective Single-Center Study Based on the EQ-5D Assessment Tool

Poprawa jakości życia w perspektywie krótkoterminowej u pacjentów po pomostowaniu aortalno-wieńcowym – prospektywne, jednoośrodkowe badanie kliniczne oparte na kwestionariuszu EQ-5D

Łukasz Kołtowski1,, Anna Drohomirecka2,, Mateusz Palczewski2,, Romuald Cichoń2,

1 1st Department of Cardiology, Medical University of Warsaw, Poland

2 Medinet Heart Center, Wrocław, Poland

Abstract

Background. Most cardiac patients believe that a heart operation will considerably improve their daily activities and quality of life (QoL). The question is how quickly it will happen. As the answer to this question is not strictly tied to medical outcomes, the authors decided to turn to the patients as a source.
Objectives. To determine the health-related QoL of heart surgery patients before surgery and to evaluate the change of QoL over the first month after operation.
Material and Methods. The study involved 86 coronary artery bypass grafting (CABG) patients (59 male; mean age = 63.3, SD = 8.93). Their QoL was measured by the EQ-5DVAS, which records the respondent’s self-rated health status on a vertical visual analogue scale (VAS) of 0–100, in which 0 represents the worst imaginable state of health and 100 is the best imaginable. The patients’ QoL was assessed at three points in time: on the day of admission (P1), 6 days after surgery (P2) and in the fourth week after the procedure (P3).
Results. The average QoL just before surgery (P1) was 61.9 (SD = 18.85). No major improvement in the QoL was achieved after 6 days (P2) (61.97, p > 0.05), but in the following 4 weeks the QoL increased dramatically (P3) (67.93, p > 0.05). It was observed that the QoL was associated with the patient age. In older patients there was a temporary drop at P2, whereas in younger patients there was a constant rise through the 4th post-operative week. Neither the type of procedure (on-pump vs off-pump) nor gender had any significant influence on the level of the QoL.
Conclusion. The quality of life significantly improves in the first 4 weeks after cardiac surgery. There is a relation between the patient’s age and their reported QoL in the very early post-operative period. Further studies are needed to determine which areas of post-operative care of older patients require greater attention.

Streszczenie

Wprowadzenie. Pacjenci poddani pomostowaniu aortalno-wieńcowemu (CABG) oczekują poprawy jakości życia (QoL), nie mają jednak pewności, jak szybko mogą się jej spodziewać. Aby odpowiedzieć na to pytanie, przeprowadzono prospektywne, jednoośrodkowe badanie w Dolnośląskim Centrum Chorób Serca Medinet.
Cel pracy. Ocena jakości życia we wczesnym okresie pooperacyjnym u pacjentów poddanych zabiegowi CABG.
Materiał i metody. Do badania włączono 86 pacjentów poddanych CABG (59 mężczyzn; średni wiek [SD]: 63,3 [8,93]). Ocenę jakości życia przeprowadzono na podstawie kwestionariusza EQ-5D i skali VAS (visual analogue scale) o wartościach od 0 (najgorszy wyobrażalny stan zdrowia) do 100 (najlepszy wyobrażalny stan zdrowia). Jakość życia była mierzona w trzech punktach czasowych: dzień przed zabiegiem (P1), 6 dni po zabiegu (P2) i w 4. tygodniu po zabiegu (P3).
Wyniki. Średnia QoL w P1 wyniosła 61,9 (SD: 18,85), nie odnotowano istotnej poprawy w P2, QoL = 61,97 (p > 0,05), QoL istotnie poprawiła się natomiast w P3 – do poziomu 67,93 (p > 0,05). Czynnikiem wpływającym na QoL był wiek, u osób starszych rejestrowano przejściowe pogorszenie QoL w P2. Na QoL nie wpływały: rodzaj zabiegu (z lub bez użycia krążenia pozaustrojowego) ani płeć.
Wnioski. QoL zmienia się w okresie okołooperacyjnym i istotnie poprawia się w pierwszych 4 tygodniach po zabiegu. Istnieje zależność między starszym wiekiem a postrzeganym poziomem QoL w 6. dniu po zabiegu. Być może przyszłe badania odpowiedzą na pytanie, czy starsi pacjenci wymagają odmiennej opieki w pierwszych tygodniach po zabiegu.

Key words

CABG, QoL, EQ-5D, EuroQol, EuroScore

Słowa kluczowe

CABG, jakość życia, EQ-5D, EuroScore, choroba wieńcowa

References (17)

  1. Chait LO: Use of select mortality tables to reevaluate CABG. Circulation 1982, 65, 1286.
  2. McDonald CJ, Fitzgerald JF: CABG surgical mortality in different centers. JAMA 1992, 267, 932–933.
  3. Choudary J, Arif I, Helmy T: Multivessel pci versus CABG, One-year outcomes and cost analysis. J Invasive Cardiol 2007, 19, 476–477.
  4. Bross W, Bross T, Koltowski R, Kustrzyski A, Olejak B, Dymala L, Masiak M, Crzereda T, Kibler J, Krupacz R, Ostapczuk S, Michel AJ: Treatment of cerebral embolism in heart surgery. Ann Chir Gynaecol Fenn 1975, 64, 280–283.
  5. Hoffman SN, TenBrook JA, Wolf MP, Pauker SG, Salem DN, Wong JB: A meta-analysis of randomized controlled trials comparing coronary artery bypass graft with percutaneous transluminal coronary angioplasty. Oneto eight-year outcomes. J Am Coll Cardiol 2003, 41, 1293–1304.
  6. Long-term results of prospective randomized study of coronary artery bypass surgery in stable angina pectoris. European coronary surgery study group. Lancet 1982, 2, 1173–1180.
  7. Fox NL, Hoogwerf BJ, Czajkowski S, Lindquist R, Dupuis G, Herd JA, Campeau L, Hickey A, Barton FB, Terrin ML: Quality of life after coronary artery bypass graft: results from the post cabg trial. Chest 2004, 126, 487–495.
  8. Ross AC, Ostrow L: Subjectively perceived quality of life after coronary artery bypass surgery. Am J Crit Care 2001, 10, 11–16.
  9. Nashef SA, Roques F, Hammill BG, Peterson ED, Michel P, Grover FL, Wyse RK, Ferguson TB: Validation of european system for cardiac operative risk evaluation (euroscore) in north american cardiac surgery. Eur J Cardiothorac Surg 2002, 22, 101–105.
  10. Williams A: University of York. Centre for Health Economics, York Health Economics Consortium, University of York. NHS Centre for Reviews & Dissemination. The role of the euroqol instruments in qaly calculations [York, England: Centre for Health Economics, University of York], 1995.
  11. Gosset W: The probable error of a mean. Biometrika 1908, 6, 25.
  12. Mogull RG: Second-semester applied statistics. Kendall/Hunt Publishing Company, 2004.
  13. Galton F: Kinship and correlation (reprinted 1989). Statist Sci 1989, 4, 80–86.
  14. Roques F, Nashef SA, Michel P, Gauducheau E, de Vincentiis C, Baudet E, Cortina J, David M, Faichney A, Gabrielle F, Gams E, Harjula A, Jones MT, Pintor PP, Salamon R, Thulin L: Risk factors and outcome in european cardiac surgery: analysis of the euroscore multinational database of 19030 patients. Eur J Cardiothorac Surg 1999, 15, 816–822, discussion 822–813.
  15. Favarato ME, Hueb W, Boden WE, Lopes N, Nogueira CR, Takiuti M, Gois AF, Borges JC, Favarato D, Aldrighi JM, Oliveira SA, Ramires JA: Quality of life in patients with symptomatic multivessel coronary artery disease: a comparative post hoc analysis of medical, angioplasty or surgical strategies-mass ii trial. Int J Cardiol 2007, 116, 364–370.
  16. Najafi M, Sheikhvatan M, Montazeri A: Quality of life-associated factors among patients undergoing coronary artery bypass surgery as measured using the whoqol-bref. Cardiovasc J Afr 2009, 20, 284–289.
  17. Maggioni AP, Dahlstrom U, Filippatos G, Chioncel O, Leiro MC, Drozdz J, Fruhwald F, Gullestad L, Logeart D, Metra M, Parissis J, Persson H, Ponikowski P, Rauchhaus M, Voors A, Nielsen OW, Zannad F, Tavazzi L: Eurobservational research programme: The heart failure pilot survey (esc-hf pilot). Eur J Heart Fail 2010, 12, 1076–1084.
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