Quality of life after coronary bypass: a multicentre study of routinely collected health data in the Netherlands†

Abstract

Objectives: In this study, our aim was to explore how coronary artery bypass grafting affects quality of life, and how this varies with age, particularly with patients at risk of deterioration.

Methods: In a retrospective, multicentre cohort study, patients with isolated coronary artery bypass grafting and electively operated between January 2011 and January 2015 with pre- and postoperative quality-of-life data were included. Patients were classified into 3 age groups: <65, 65-79 and ≥80 years. Quality of life was measured up to 1-year follow-up using the Short Form-12 or the Short Form-36 health survey. A multivariable, linear regression analysis, with an adjustment for confounders, was used to evaluate the association between age and quality of life.

Results: A total of 2606 patients were included in this study. Upon one-year of follow-up, the mean physical health of patients increased from 54 at baseline to 68, and mental health increased from 60 to 67. We observed decreased mental health in 20% of patients aged <65 years, 20% of patients aged 65-79 years and 29% of patients aged ≥80 years (P = 0.039). In this study, age was not associated with a lower physical or mental component score (P = 0.054 and P = 0.13, respectively). Independent risk factors for a decrease in quality of life consist of a better physical and mental score at baseline (P < 0.001) and a reduced left ventricular function (P < 0.001).

Conclusions: Most patients experience a relevant increase in physical and mental quality of life, but a proportion of patients aged ≥80 years undergo significant deterioration in mental health.

Keywords: Cardiac surgery; Coronary artery bypass grafting; Quality of life.

Figure 1:

Quality-of-life data of patients with coronary artery bypass grafting according to age categories. Mean scores of the physical and the mental health component scores (with 95% confidence intervals) of patients with coronary artery bypass grafting before and 1 year after surgery for each age category.

Figure 2:

(A) Difference in QoL of patients with coronary artery bypass grafting: physical component score. Differences between baseline and 1-year follow-up per age group, in the quality of life physical component score; cut-off value 5 points. (B) Difference in quality of life of patients with coronary artery bypass grafting: the mental component score. Differences between baseline and 1-year follow-up per age group, in the quality of life mental component score; cut-off value 5 points. QoL: quality of life.