A multinational study of the influence of health-related quality of life on in-hospital outcome after coronary artery bypass graft surgery

• Published in: The American heart journal Vol. 161; no. 6; pp. 1179 - 1185.e2
• Main Authors: Székely, Andrea, MD, PhD, Nussmeier, Nancy A., MD, Miao, Yinghui, MD, MPH, Huang, Kun, MSPH, Levin, Jack, MD, Feierfeil, Helena, MD, Mangano, Dennis T., MD, PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-06-2011; Mosby; Elsevier Limited
• Subjects: Aged; Angioplasty; Biological and medical sciences; Cardiology. Vascular system; Cardiovascular; Coronary Artery Bypass; Coronary heart disease; Coronary vessels; Female; Health Status; Health Status Indicators; Heart; Heart attacks; Hospital Mortality; Hospitals; Humans; Length of Stay; Male; Medical sciences; Mortality; Outcome Assessment (Health Care); Quality of Life; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Prognosis; Treatment; Coronary artery bypass; Health; Graft; Cardiovascular disease; Circulatory system; Hospital; Cardiology; Coronary heart disease; Quality of life
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1016/j.ahj.2011.03.012

Background The effect of health-related quality of life on in-hospital outcomes after coronary artery bypass grafting surgery has not been investigated in international multicenter studies. We hypothesized that poor preoperative health status is associated with mortality and length of hospital stay. Methods In the Multicenter Study of Perioperative Ischemia Epidemiology II, preoperative Short-Form 12, Mental Component Summary (MCS), and Physical Component Summary (PCS) scores were obtained prospectively from 4,811 patients (3,834 men, 977 women) undergoing coronary artery bypass grafting surgery at 72 centers in 17 countries. Primary outcome measures were in-hospital mortality and prolonged (>14 days) length of hospital stay. Results One hundred fifty-one patients (3.1%) died. After adjustment for regional differences, a 10-point reduction in MCS score was associated with higher mortality risk (odds ratio [OR] 1.17, 95% CI 1.004-1.37, P = .04) and prolonged hospital stay (OR 1.11, 95% CI 1.01-1.21, P = .03). The preoperative PCS score was not associated with mortality risk but significantly predicted prolonged length of hospital stay (OR 1.20, 95% CI 1.09-1.33, P < .001). There was no significant interaction between gender and either the MCS or the PCS score. Discussion The preoperative PCS predicted prolonged postoperative hospital stay, whereas the preoperative MCS score was an independent predictor of both prolonged length of hospital stay and mortality. Preoperative assessment of health-related quality of life factors with the Short-Form 12 might be a useful tool for risk stratification and planning for hospital discharge and rehabilitation.