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European Journal of Cardio-Thoracic Surgery, Vol 12, 612-619, Copyright © 1997 by European Association for Cardio-thoracic Surgery
H Sjoland, K Caidahl, I Wiklund, M Haglid, M Hartford, BW Karlson, T Karlsson and J Herlitz
OBJECTIVE: To prospectively study the improvement in quality of life (QoL)
after coronary artery bypass surgery (CABG). PATIENTS AND METHODS:
Consecutive patients (n = 2121) who underwent CABG at Sahlgrenska
University Hospital between 1988 and 1991 received 3 questionnaires for the
study of QoL: the Physical Activity Score, the Nottingham Health Profile
and the Psychological General Well-being Index, which were responded both
before surgery and at 3 months (n = 1059), 1 year (n = 1045) and 2 years (n
= 1027) postoperatively. RESULTS: All differences were tested against
baseline. The Physical Activity Score improved (mean 4.3 before CABG, 3.1,
3 months after (P < 0.0001), and 2.8, 2 years postoperatively (P <
0.0001)). The Nottingham Health Profile score improved (mean 20.5 before
CABG, 11.4, 3 months (P < 0.0001), and 10.4, 2 years postoperatively (P
< 0.0001)). The Psychological General Well-being Index improved (mean
91.1 before CABG, 103.8, 3 months (P < 0.0001), and 105.8 (P <
0.0001), 2 years after CABG). The subscale analyses of the Nottingham
Health Profile and the Psychological General Well-being Index 2 years after
CABG showed the greatest improvement in areas reflecting physical capacity
and pain, to be followed by mental qualities. At 2 years after CABG only
sexual problems were still markedly frequent, and independent predictors
for sexual problems after surgery were preoperative problems (P <
0.00001), male sex (P < 0.0001), and diabetes mellitus (P = 0.0008).
CONCLUSION: QoL was markedly and significantly improved after CABG. The
major improvement was seen already at 3 months, with further slight
improvement observed 2 years after surgery. The major improvement was found
in areas reflecting physical capacity and pain, which is consistent with
symptomatic and objective measurements after CABG. In contrast to the
overall improvement in QoL sexual problems were still markedly common 2
years after CABG. The mechanism for this is not fully understood and needs
further investigation.
ARTICLES
Impact of coronary artery bypass grafting on various aspects of quality of life
Division of Cardiology, Sahlgrenska University Hospital, Goteborg, Sweden.
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