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Eur J Cardiothorac Surg 2006;30:294-299
© 2006 Elsevier Science NL

Health-related quality of life following off-pump versus on-pump coronary artery bypass grafting in elderly moderate to high-risk patients: a randomized trial

Birte Østergaard Jensen^a,_*, Pia Hughes^a,c,, Lars S. Rasmussen^b, Preben U. Pedersen^a, Daniel A. Steinbrüchel^a

^a Department of Cardiothoracic Surgery, The Heart Center, Rigshospitalet, Copenhagen University Hospital, Section 9441, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
^b Department of Anesthesia, Center of Head and Orthopaedics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
^c Copenhagen Trial Unit, Center for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark

Received 9 January 2006; received in revised form 27 March 2006; accepted 11 April 2006.

^_* Corresponding author. Tel.: +45 3545 2938; fax: +45 3545 2548. (Email: Birtej{at}rh.dk).

Objective: Previous trials comparing coronary artery bypass grafting (CABG) with or without extracorporeal circulation have mainly enrolled selected patients at younger age and low risk. Patient-reported health-related quality of life has not been significantly different. We compared health-related quality of life in elderly moderate to high-risk patients randomized to either off-pump or on-pump surgery. Methods: The study is a sub-study of the randomized Best Bypass Surgery Trial that compares off-pump to on-pump treatment, with respect to peri- and postoperative mortality and morbidity in patients with a moderate to high-predicted preoperative risk. After randomization and before heart surgery, 120 consecutive patients were asked to fill in the Medical Outcomes Study Short Form 36 (SF-36) and Major Depression Inventory (MDI) diagnostic scale for self-report of health-related quality of life. Three months after surgery, the same questionnaires were mailed to the patients. Results: The response rate was 96.5%. At baseline, the groups were comparable except for a difference in educational level. Both groups improved in all eight SF-36 domains from baseline to 3 months. No statistical differences were seen between the groups except for changes in mean difference of role limitation due to emotional problems, which was significantly (P = .04) improved in favour of the on-pump group. Depression scores remained unchanged within and between the two surgical groups. Conclusions: Both on-pump and off-pump patients improved in health-related quality of life scores after CABG surgery. No clinically relevant difference between the groups could be demonstrated.

Key Words: Coronary artery bypass surgery • Off-pump • On-pump • Health-related quality of life • Quality of life • Depression