Functional Status Indicators and Long-Term Mortality Following Elective Coronary Artery Bypass Grafting: A...

Area of Science:

• Cardiology
• Health Services Research
• Outcomes Research

Background:

• Coronary artery bypass grafting (CABG) is a prevalent major surgical procedure globally.
• The prognostic significance of preoperative functional status for long-term mortality post-CABG requires further elucidation.
• Key functional indicators include self-perceived health, MacNew physical domain score, and estimated maximum oxygen consumption.

Purpose of the Study:

• To evaluate the prognostic value of preoperative functional status indicators for long-term mortality in patients undergoing CABG.
• To compare the predictive power of self-perceived health, MacNew physical domain score, and estimated maximum oxygen consumption.

Main Methods:

• A cohort of 1146 patients undergoing CABG across 7 Israeli hospitals was analyzed.
• Functional status was assessed using self-perceived health, MacNew physical domain score, and estimated maximum oxygen consumption.
• Multivariable Cox regression models were employed to examine associations with all-cause mortality.

Main Results:

• Over a median follow-up of 15.4 years, 59.6% of patients died.
• Impaired self-perceived health emerged as the strongest mortality predictor (HR, 1.43; P<0.001).
• Low maximum oxygen consumption (HR, 1.2; P=0.05) and poor MacNew physical score (HR, 1.2; P=0.02) also predicted mortality, but with less accuracy than self-perceived health.

Conclusions:

• Self-perceived health offers superior prognostic value for long-term mortality compared to other functional status measures after CABG.
• This single-question indicator of self-perceived health should be incorporated into risk stratification and prognosis assessment for CABG patients.