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THE ASSOCIATION OF HEALTH RELATED QUALITY OF LIFE AND INCREASING AGE FOLLOWING CORONARY ARTERY BYPASS GRAFTING
October 2008, Vol 134, No. 4_MeetingAbstracts Abstract: Slide Presentations | October 2008
THE ASSOCIATION OF HEALTH RELATED QUALITY OF LIFE AND INCREASING AGE FOLLOWING CORONARY ARTERY BYPASS GRAFTING Lisa M. Martin, PhD*; Scott D. Barnett, PhD; Sharon L. Hunt, MBA; Linda L. Henry, PhD; Niv Ad, MD Inova Heart and Vascular Institute, Falls Church, VA Chest. 2008;134(4_MeetingAbstracts):s44004. doi:10.1378/chest.134.4_MeetingAbstracts.s44004
Abstract PURPOSE:Coronary artery bypass grafting (CABG) among patients ≥ 75 years of age is commonplace with the incidence of perioperative outcomes slightly increased over younger patients. In this report, we examine the health-related quality of life (HRQL), perioperative morbidity, and survival of such patients. METHODS:Subjects were 594 isolated, first time, CABG patients operated with baseline HRQL scores dichotomized for analysis into Group 1 (age < 75) and Group 2 (age ≥ 75). HRQL was measured by the Short-Form 12. Composite Physical (CPS), Composite Mental (CMS) Scores, and General Health (GH) metrics were utilized. RESULTS:Group 1 (n=506) and Group 2 (n=88) patients were primarily male (83.0% vs. 69.0%, p<0.001) with Group 2 at significantly increased risk of a major perioperative morbidity / mortality (3.1% vs. 1.2%, p<0.001) following surgery. Group 2 patients experienced only an increased risk of prolonged ventilation (6.8% vs. 1.6%, p<0.003), perioperative atrial fibrillation (18.2% vs. 8.5%, p<0.005) and 30 day mortality (4.6% vs. 0.6%, p<0.005). Group 2 scored comparable to Group 1 patients for baseline CPS (43.5 vs. 44.2, p<0.025), CMS (51.2 vs. 51.5, p<0.168) and GH (68.4 vs. 62.7, p<0.148). At 6 months, Group 2 reported higher CPS (43.6 vs. 47.2, p<0.623), CMS (54.9 vs. 53.1, p<0.045) and GH (68.1 vs. 73.2, p<0.180). Survival among patients with at least 1 year of follow-up (n=307) was 96.7%. Five (Group 1: 2.0% 5/257; Group 2: 10.0% 5/50 deaths were observed within the first postoperative year with a significant increased hazard of death due to age ≥ 75 years (Hazard 1.50; 95% CI: 1.45–17.30). A decreased CPS score at baseline was a significant risk factor for 1-year death (Hazard 0.93; 95% CI: 0.88–0.99). No gender interaction was observed.
CONCLUSION:Patients aged ≥ 75 fare well in CPS, CMS, and GH following first time, isolated CABG. CLINICAL IMPLICATIONS:Age ≥ 75 and physical HRQL assessment at time of surgery do predict survival at 1-year but mental and general health HRQL assessments at time of surgery carry little predictive value. DISCLOSURE:Lisa Martin, No Financial Disclosure Information; No Product/Research Disclosure Information Tuesday, October 28, 2008 2:30 PM - 4:00 PM
THE ASSOCIATION OF HEALTH RELATED QUALITY OF LIFE AND INCREASING AGE FOLLOWING CORONARY ARTERY BYPASS GRAFTING Lisa M. Martin, PhD*; Scott D. Barnett, PhD; Sharon L. Hunt, MBA; Linda L. Henry, PhD; Niv Ad, MD Inova Heart and Vascular Institute, Falls Church, VA Chest. 2008;134(4_MeetingAbstracts):s44004. doi:10.1378/chest.134.4_MeetingAbstracts.s44004
Abstract PURPOSE:Coronary artery bypass grafting (CABG) among patients ≥ 75 years of age is commonplace with the incidence of perioperative outcomes slightly increased over younger patients. In this report, we examine the health-related quality of life (HRQL), perioperative morbidity, and survival of such patients. METHODS:Subjects were 594 isolated, first time, CABG patients operated with baseline HRQL scores dichotomized for analysis into Group 1 (age < 75) and Group 2 (age ≥ 75). HRQL was measured by the Short-Form 12. Composite Physical (CPS), Composite Mental (CMS) Scores, and General Health (GH) metrics were utilized. RESULTS:Group 1 (n=506) and Group 2 (n=88) patients were primarily male (83.0% vs. 69.0%, p<0.001) with Group 2 at significantly increased risk of a major perioperative morbidity / mortality (3.1% vs. 1.2%, p<0.001) following surgery. Group 2 patients experienced only an increased risk of prolonged ventilation (6.8% vs. 1.6%, p<0.003), perioperative atrial fibrillation (18.2% vs. 8.5%, p<0.005) and 30 day mortality (4.6% vs. 0.6%, p<0.005). Group 2 scored comparable to Group 1 patients for baseline CPS (43.5 vs. 44.2, p<0.025), CMS (51.2 vs. 51.5, p<0.168) and GH (68.4 vs. 62.7, p<0.148). At 6 months, Group 2 reported higher CPS (43.6 vs. 47.2, p<0.623), CMS (54.9 vs. 53.1, p<0.045) and GH (68.1 vs. 73.2, p<0.180). Survival among patients with at least 1 year of follow-up (n=307) was 96.7%. Five (Group 1: 2.0% 5/257; Group 2: 10.0% 5/50 deaths were observed within the first postoperative year with a significant increased hazard of death due to age ≥ 75 years (Hazard 1.50; 95% CI: 1.45–17.30). A decreased CPS score at baseline was a significant risk factor for 1-year death (Hazard 0.93; 95% CI: 0.88–0.99). No gender interaction was observed.
CONCLUSION:Patients aged ≥ 75 fare well in CPS, CMS, and GH following first time, isolated CABG. CLINICAL IMPLICATIONS:Age ≥ 75 and physical HRQL assessment at time of surgery do predict survival at 1-year but mental and general health HRQL assessments at time of surgery carry little predictive value. DISCLOSURE:Lisa Martin, No Financial Disclosure Information; No Product/Research Disclosure Information Tuesday, October 28, 2008 2:30 PM - 4:00 PM