A comparative study of patient perceived quality of life pre and post coronary artery bypass graft surgery

OBJECTIVE: Traditionally, evaluation of outcome post cardiac surgery has focused on objective measures of cardiovascular status. The emphasis has shifted to examining an individual's quality of life (QoL). However a gap in Australian prospective research assessing QoL from a pre-operative period to the early stage of six weeks post-operatively exists. The aim of this study was to investigate recovery from coronary artery bypass graft surgery (CABGS) on the basis of patient perceived QoL and in particular, physical and mental health. DESIGN AND SETTING: Prospective longitudinal quasi-experimental study in a tertiary hospital in Melbourne, Australia. SUBJECTS: Fifty four patients undergoing their first or second CABGS completed pre- and post-operative questionnaires. MAIN OUTCOME MEASURES: The Short Form 36 (SF-36) questionnaire was used to measure physical and mental QoL pre- and post CABGS and gives eight domain scores as well as a physical (PCS) and mental component summary score (MCS). RESULTS: SF-36 scores following CABGS were significantly improved in three of the eight domains: physical functioning (p < 0.001); general health perception (p < 0.001); energy/vitality (p < 0.005); and PCS (p < 0.001). No statistical difference was found in patients' MCS pre- and post-operatively. Of importance, patients reported higher levels of pain at six weeks post-operatively compared to their pre-operative levels but scores were not significantly different. CONCLUSIONS: The SF-36 demonstrates improvements in physical QoL six weeks after CABGS compared to preoperative results but no difference in mental QoL suggesting psychological adaptation. An increase in the pain score at six weeks suggests inadequate pain management in these patients.