Advances in Clinical and Experimental Medicine

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Advances in Clinical and Experimental Medicine

2011, vol. 20, nr 4, July-August, p. 447–453

Publication type: original article

Language: English

Short-Term Improvement of Patients’ Quality of Life After Coronary Artery Bypass Grafting – a Prospective Single-Center Study Based on the EQ-5D Assessment Tool

Poprawa jakości życia w perspektywie krótkoterminowej u pacjentów po pomostowaniu aortalno-wieńcowym – prospektywne, jednoośrodkowe badanie kliniczne oparte na kwestionariuszu EQ-5D

Łukasz Kołtowski1,, Anna Drohomirecka2,, Mateusz Palczewski2,, Romuald Cichoń2,

1 1st Department of Cardiology, Medical University of Warsaw, Poland

2 Medinet Heart Center, Wrocław, Poland

Abstract

Background. Most cardiac patients believe that a heart operation will considerably improve their daily activities and quality of life (QoL). The question is how quickly it will happen. As the answer to this question is not strictly tied to medical outcomes, the authors decided to turn to the patients as a source.
Objectives. To determine the health-related QoL of heart surgery patients before surgery and to evaluate the change of QoL over the first month after operation.
Material and Methods. The study involved 86 coronary artery bypass grafting (CABG) patients (59 male; mean age = 63.3, SD = 8.93). Their QoL was measured by the EQ-5DVAS, which records the respondent’s self-rated health status on a vertical visual analogue scale (VAS) of 0–100, in which 0 represents the worst imaginable state of health and 100 is the best imaginable. The patients’ QoL was assessed at three points in time: on the day of admission (P1), 6 days after surgery (P2) and in the fourth week after the procedure (P3).
Results. The average QoL just before surgery (P1) was 61.9 (SD = 18.85). No major improvement in the QoL was achieved after 6 days (P2) (61.97, p > 0.05), but in the following 4 weeks the QoL increased dramatically (P3) (67.93, p > 0.05). It was observed that the QoL was associated with the patient age. In older patients there was a temporary drop at P2, whereas in younger patients there was a constant rise through the 4th post-operative week. Neither the type of procedure (on-pump vs off-pump) nor gender had any significant influence on the level of the QoL.
Conclusion. The quality of life significantly improves in the first 4 weeks after cardiac surgery. There is a relation between the patient’s age and their reported QoL in the very early post-operative period. Further studies are needed to determine which areas of post-operative care of older patients require greater attention.

Streszczenie

Wprowadzenie. Pacjenci poddani pomostowaniu aortalno-wieńcowemu (CABG) oczekują poprawy jakości życia (QoL), nie mają jednak pewności, jak szybko mogą się jej spodziewać. Aby odpowiedzieć na to pytanie, przeprowadzono prospektywne, jednoośrodkowe badanie w Dolnośląskim Centrum Chorób Serca Medinet.
Cel pracy. Ocena jakości życia we wczesnym okresie pooperacyjnym u pacjentów poddanych zabiegowi CABG.
Materiał i metody. Do badania włączono 86 pacjentów poddanych CABG (59 mężczyzn; średni wiek [SD]: 63,3 [8,93]). Ocenę jakości życia przeprowadzono na podstawie kwestionariusza EQ-5D i skali VAS (visual analogue scale) o wartościach od 0 (najgorszy wyobrażalny stan zdrowia) do 100 (najlepszy wyobrażalny stan zdrowia). Jakość życia była mierzona w trzech punktach czasowych: dzień przed zabiegiem (P1), 6 dni po zabiegu (P2) i w 4. tygodniu po zabiegu (P3).
Wyniki. Średnia QoL w P1 wyniosła 61,9 (SD: 18,85), nie odnotowano istotnej poprawy w P2, QoL = 61,97 (p > 0,05), QoL istotnie poprawiła się natomiast w P3 – do poziomu 67,93 (p > 0,05). Czynnikiem wpływającym na QoL był wiek, u osób starszych rejestrowano przejściowe pogorszenie QoL w P2. Na QoL nie wpływały: rodzaj zabiegu (z lub bez użycia krążenia pozaustrojowego) ani płeć.
Wnioski. QoL zmienia się w okresie okołooperacyjnym i istotnie poprawia się w pierwszych 4 tygodniach po zabiegu. Istnieje zależność między starszym wiekiem a postrzeganym poziomem QoL w 6. dniu po zabiegu. Być może przyszłe badania odpowiedzą na pytanie, czy starsi pacjenci wymagają odmiennej opieki w pierwszych tygodniach po zabiegu.

Key words

CABG, QoL, EQ-5D, EuroQol, EuroScore

Słowa kluczowe

CABG, jakość życia, EQ-5D, EuroScore, choroba wieńcowa

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