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Measuring function in older adults with co-morbid illnesses who are undergoing coronary artery bypass graft (CABG)

Monica Parry1, Heather Arthur, Dina Brooks

  • 1Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Suite 130, Toronto, ON, Canada. monica.parry@utoronto.ca

Archives of Gerontology and Geriatrics
|July 2, 2011
PubMed

Insights

The Human Activity Profile (HAP) better measures functional changes after coronary artery bypass grafting (CABG) surgery in patients with multiple health issues compared to the SF-36v2™ instrument.

Area of Science:

  • Cardiology
  • Rehabilitation Medicine
  • Health Outcomes Research

Background:

  • Measuring functional outcomes after Coronary Artery Bypass Grafting (CABG) surgery presents challenges due to diverse patient abilities and co-morbidities.
  • An increasing number of older patients with multiple health conditions are undergoing CABG surgery.
  • Traditional generic instruments may lack sensitivity in assessing functional differences in this complex patient group.

Purpose of the Study:

  • To compare the efficacy of the Human Activity Profile (HAP) against the Medical Outcome Study Short Form 36 (SF-36v2™) in evaluating functional status post-CABG surgery.
  • To assess the correlation between the Functional Comorbidity Index (FCI) and functional measures in patients undergoing CABG.
  • To determine if the HAP is more sensitive than the SF-36v2™ in detecting functional decrements associated with co-morbidities in CABG patients.

Main Methods:

  • A cohort of 101 patients (84 men, 17 women, mean age 63) undergoing CABG surgery was studied.
  • Patients completed the Human Activity Profile (HAP) and the SF-36v2™.
  • The Functional Comorbidity Index (FCI) was used to quantify co-morbidities, with 82% having three to six co-morbid illnesses.

Main Results:

  • Significant negative correlations were found between FCI scores and HAP's Maximum Activity Score (MAS) (r=-0.32, p=0.002) and Adjusted Activity Score (AAS) (r=-0.29, p=0.004).
  • Higher co-morbidity scores were associated with lower functional capacity as measured by the HAP.
  • A non-significant negative correlation was observed between FCI scores and the SF-36v2™ Physical Component Summary (PCS) (r=-0.19, p=0.07).

Conclusions:

  • The Human Activity Profile (HAP) appears more sensitive than the SF-36v2™ Physical Component Summary (PCS) in detecting functional differences in CABG patients with co-morbidities.
  • Findings suggest that generic functional measures may not adequately capture the nuances of functional status in complex patient populations.
  • Further research is warranted to validate the HAP's utility in diverse populations burdened by co-morbidities.

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