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CLINICAL RESEARCH: CARDIAC SURGERY

The elderly: health status benefits and recovery of function one year after coronary artery bypass surgery

^* Mid America Heart Institute of Saint Luke's Hospital and the University of Missouri-Kansas City, Kansas City, Missouri, USA.

^* Reprint requests and correspondence: Dr. John A. Spertus, Director of Cardiovascular Education and Outcomes Research, 4401 Wornall Road, Kansas City, Missouri 64111, USA.
spertusj{at}umkc.edu

OBJECTIVES: The purpose of this study was to describe the health status (symptoms, function, and quality of life) changes of elderly patients undergoing coronary artery bypass grafting (CABG) and compare these to younger patients.

BACKGROUND: Despite increasing use of CABG in the elderly, few data exist about elderly patients' health status benefits from CABG.

METHODS: A total of 690 consecutive patients (n = 156, >75 years of age; n = 534, 75 years of age) from a single center were administered the Seattle Angina Questionnaire (SAQ) at baseline and at one year. The first 224 patients were also given monthly questionnaires for six months after CABG.

RESULTS: Although peri-operative mortality was similar (2.6% vs. 2.2%, p = NS), one-year mortality was greater in older patients (11.5% vs. 5.4%, p = 0.008). Among survivors, similar health status benefits were observed one year after surgery (SAQ change scores for Physical Function 21.5 ± 27.0 vs. 19.7 ± 27.0, p = 0.67; Angina Frequency 30.1 ± 25.7 vs. 24.6 ± 25.6, p = 0.07; and Quality of Life 37.7 ± 21.8 vs. 33.6 ± 25.2, p = 0.16). In 224 patients assessed monthly, elderly patients' physical function scores were significantly lower than the younger group until one year. The age-time interaction term was significant (p = 0.003), confirming a slower recovery of physical function. In contrast, angina relief and quality of life improvement did not differ by age.

CONCLUSIONS: Despite a slower rate of physical recovery, older patients derived similar health status benefits from CABG compared with younger patients. These data should assist physicians in counseling elderly patients and suggest that age alone should not be a deterrent for recommending bypass surgery.

Abbreviations and Acronyms   CABG = coronary artery bypass grafting surgery   CHF = congestive heart failure   SAQ = Seattle Angina Questionnaire

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