Key result
CABG in patients over 70 shows 1-month functional decline followed by 6-month recovery.
Why the study?
Does coronary artery bypass grafting affect functional status over 6 months in elderly patients aged ≥60 years?
Cohort (n=73)
Does coronary artery bypass grafting affect functional status over 6 months in elderly patients aged ≥60 years?
p-value: p=<0.001
Elderly patients undergoing CABG experience a significant functional decline at 1 month post-discharge with partial recovery by 6 months, which can be effectively tracked using the Functional Independence Measure.
Early functional decline after CABG in elderly patients should not change practice; leaves open need for prospective trials on mitigation.
AIM: To determine longitudinal changes in functional status using three functional assessment scales in elderly patients undergoing coronary artery bypass grafting. METHODS: This was a prospective observational cohort study of 73 patients aged ≥60 years undergoing elective coronary artery bypass grafting. Patients were assessed for functional status before admission, at hospital discharge, and at 1 and 6 months after discharge using the Functional Independence Measure, Katz Activities of Daily Living scale, and Lawton Instrumental Activities of Daily Living scale. Data were stratified by age (≥70 years and <70 years) and complications (with and without) for analysis. RESULTS: In patients aged ≥70 years (n = 38), Functional Independence Measure scores ranged from 121.30 ± 6.42 (pre-admission) to 112.10 ± 17.10 (1 month) and 117.80 ± 13.50 (6 months), Katz scores from 5.88 ± 0.32 (pre-admission) to 5.45 ± 1.04 (1 month) and 5.83 ± 0.65 (6 months), and Lawton scores from 25.40 ± 3.30 (pre-admission) to 20.05 ± 4.93 (1 month) and 24.50 ± 4.10 (6 months; P < 0.001 for all). No significant changes were found in scale scores over time between groups with (n = 34) and without (n = 39) complications. When groups aged ≥70 years (n = 38) and <70 (n = 35) were compared, Functional Independence Measure scores showed a difference toward recovery over time in older patients (discharge - pre-admission, P = 0.010; 1 month - pre-admission, P = 0.0004; and 6 months - pre-admission, P = 0.079). CONCLUSIONS: The Functional Independence Measure was able to detect significant functional loss over a 6-month period in elderly patients undergoing coronary artery bypass grafting, suggesting that this scale is a promising tool for the assessment of functional recovery over time after cardiac surgery, especially in patients aged older than 70 years. Geriatr Gerontol Int 2015; ●●: ●●-●●.
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Guimarães et al. (2015) conducted a cohort in Coronary artery disease requiring CABG (n=73). Coronary artery bypass grafting (CABG) vs. Age <70 years and patients without complications was evaluated on Longitudinal changes in functional status using FIM, Katz ADL, and Lawton IADL scales (p=<0.001). The Functional Independence Measure detected significant functional decline at 1 month and recovery by 6 months in patients aged ≥70 years undergoing coronary artery bypass grafting (P<0.001).
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