Quality of life in patients undergoing coronary revascularization

This study was aimed at the evaluation of the impact of coronary revascularization surgery on the quality of life (QOL) and identification of some variables which may contribute to influence the patients' own perception of their health condition.

We prospectively studied 150 consecutive patients subjected to isolated coronary bypass surgery during a 3-month period, with evaluation of their perception of QOL before surgery and 6 months thereafter. The measurement instruments used were the MOS Health Survey (SF-36) and the Nottingham Health Profile (NHP). Additionally, a questionnaire for identification of lifestyles was introduced.

The majority of the patients were male (94%), above 50 years of age (81%), with a low educational level (65%), married (90%) and pensioners (44%). About one third (38%) had marked physical limitations (CCS class III/IV), with comorbidity (80%), previous myocardial infarction (49%) and 3-vessel coronary disease (68%). There was no operative mortality, but 29% had postoperative complications, albeit minor in the majority. Admission time was less than 8 days in 88.6% of the cases. Surgery proved beneficial in improving QOL, with better perception after surgery in all dimensions of both measurement instruments (p < 0.001). A higher level of education was related to a better perception of the energy dimension, married patients had a better improvement in the dimensions of physical pain and social isolation. More severe preoperative angina determined less favourable scores in the dimensions of mental health, social function and vitality; comorbidity had a negative impact on vitality and physical mobility; and the number of risk factors and postoperative complications had a negative impact on the dimensions of energy and emotional reactions, and social isolation and physical function, respectively. Six months after surgery, 62% of the patients who were still working before surgery had resumed their professional activity, but about 20% had retired; the majority had adopted healthier lifestyles with a decrease in tobacco and alcohol consumption and a more balanced diet.

Coronary revascularization substantially improves QOL, with a significant impact on the clinical variables of the psycho-social dimensions.