Quality of life in elderly patients following coronary artery bypass grafting

Figures & data

Table 1 General characteristics of study subjects

	Patients with CHD			Control group			Statistical significance (P)
	Total (n=65)	Female (n=29)	Male (n=36)	Total (n=65)	Female (n=38)	Male (n=27)
Education, n (%)							0.97
Elementary	17 (26.2)	8 (27.6)	9 (25)	15 (23.1)	7 (18.4)	8 (29.6)
Vocational	14 (21.5)	5 (17.2)	9 (25)	17 (26.2)	8 (21.1)	9 (33.3)
Intermediate	17 (26.2)	10 (34.5)	7 (19.4)	17 (26.2)	10 (26.3)	7 (25.9)
High	17 (26.2)	6 (20.7)	11 (30.6)	16 (24.6)	13 (34.2)	3 (11.1)
Place of residence, n (%)							0.84
Village	28 (43.1)	13 (44.8)	15 (41.7)	28 (43.1)	16 (42.1)	12 (44.4)
City	37 (56.9)	16 (55.2)	21 (58.3)	37 (52.3)	22 (57.9)	15 (55.6)
Type of work, n (%)							0.59
Physical work	34 (52.31)	15 (51.7)	19 (52.8)	27 (41.5)	18 (47.4)	9 (33.3)
Intellectual work	31 (47.7)	14 (48.3)	17 (47.2)	38 (58.5)	20 (52.6)	18 (66.7)
Marital status, n (%)							0.01
Single	1 (1.5)	1 (3.5)	0 (0)	5 (7.7)	4 (10.5)	1 (3.7)
Married	41 (63.1)	9 (31.0)	32 (88.9)	52 (80)	31 (81.6)	21 (77.8)
Widowed	19 (29.2)	18 (62.1)	1 (2.8)	5 (7.7)	1 (2.6)	4 (14.8)
Divorced	4 (6.2)	1 (3.5)	3 (8.3)	3 (4.6)	2 (5.3)	1 (3.7)
BMI, kg/m^2 (mean ± SD)	29.8±4.3	31.6±3.7	28.3±3.9	26.3±4.0	26.4±3.3	26.2±4.9	<0.001
Smoking, n (%)							0.055
Nonsmoking	40 (61.5)	22 (75.9)	18 (50)	49 (75.4)	28 (73.7)	21 (77.8)
Smoking	24 (36.9)	7 (24.1)	17 (47.2)	13 (20)	9 (23.7)	4 (14.8)
No data	1 (1.5)	0	1 (2.8)	3 (4.6)	1 (2.6)	2 (7.4)
Employment status, n (%)							0.002
Unemployed	61 (93.9)	29 (100)	32 (88.9)	48 (73.9)	27 (71.1)	21 (77.8)
Employed	4 (6.2)	0	4 (11.1)	17 (26.2)	11 (29)	6 (22.2)

Abbreviations: BMI, body mass index; CHD, coronary heart disease; SD, standard deviation.

Table 2 Clinical characteristics of study subjects

	Patients with CHD			Statistical significance (P)
	Total (n=65)	Female (n=29)	Male (n=36)
Duration of disease, years				0.54
(mean ± SD)	11.3±8.5	10.6±9.0	11.9±8.2
Waiting time for surgery (days)				0.29
(range)	35.7–41.3	26.3–36.3	41.7–45.4
Symptoms, n (%)
Dyspnea	39 (60.0)	23 (79.3)	16 (44.4)	0.02
Chest pain	49 (75.4)	21 (72.4)	28 (77.8)	0.72
Dizziness	27 (41.5)	17 (58.6)	10 (27.8)	0.03
Tiredness	52 (80.0)	24 (82.7)	28 (77.8)	0.74
Functional class CCS, n (%)				0.009
I	0	0	0
II	20 (30.8)	17 (47.2)	3 (10.3)
III	42 (64.6)	18 (50)	24 (82.8)
IV	3 (4.6)	1 (2.8)	2 (6.9)
Functional class NYHA, n (%)				0.02
I	3 (4.6)	1 (2.8)	2 (6.9)
II	18 (27.7)	16 (44.4)	2 (6.9)
II	42 (64.6)	18 (50)	24 (82.8)
IV	2 (3.1)	1 (2.8)	1 (3.4)
Coronary artery bypass grafts, n (%)				0.93
1	10 (15.4)	7 (24.1)	3 (13.9)
2	28 (43.1)	10 (34.5)	18 (50)
3	23 (35.4)	10 (34.5)	13 (36.1)
4	4 (3.1)	2 (6.9)	2 (3.1)
Types of grafts, n (%)
Venous	10 (15.4)	3 (10.3)	7 (19.4)	0.94
Arterial	32 (49.2)	11 (37.9)	21 (58.3)	0.99
Venoarterial	23 (35.4)	15 (51.7)	8 (22.2)	0.04
EuroSCORE (mean ± SD)	2.5±1	3±0.9	2.1±0.8	<0.001
Duration of postoperative wound pain, n (%)
Up to a week	3 (4.7)	2 (6.9)	1 (2.9)	0.77
2 weeks	9 (14.1)	3 (10.3)	6 (17.1)	0.79
1 month	10 (15.6)	8 (27.6)	2 (5.7)	0.51
Over a month	42 (65.6)	16 (55.2)	26 (74.3)	0.2
Feeling after surgery
I feel much worse	2 (3.1)	0	2 (5.7)	–
No significant difference	2 (3.1)	2 (6.9)	0	–
I feel better	43 (67.2)	21 (72.4)	22 (62.9)	0.51
I changed my current lifestyle	17 (26.6)	6 (20.7)	11 (31.4)	0.64

Abbreviations: CHD, coronary heart disease; SD, standard deviation; CCS, Canadian Cardiology Society; NYHA, New York Heart Association.

Table 3 Comorbidity in study subjects

Comorbidities, n (%)	Patients with CHD			Control group			Statistical significance (P)
	Total (n=65)	Female (n=29)	Male (n=36)	Total (n=5)	Female (n=38)	Male (n=27)
Myocardial infarction in medical history	65 (100)	29 (100)	36 (100)	0	0	0	–
Hypertension	53 (81.5)	24 (82.8)	29 (80.6)	0	0	0	–
Hypercholesterolemia	65 (100)	29 (100)	36 (100)	14 (21.5)	7 (25.9)	7 (18.4)	<0.001
Diabetes mellitus	23 (35.4)	10 (34.5)	13 (36.1)	3 (4.6)	0	3 (7.9)	0.002
Orthopedic diseases	2 (3.1)	2 (6.9)	0	0	0	0	–
Neurologic diseases	1 (1.5)	0	1 (2.8)	0	0	0	–
Kidney diseases	3 (4.6)	3 (10.3)	0	2 (3.1)	2 (7.4)	0	0.88
Respiratory system diseases	9 (13.8)	4 (13.8)	5 (13.9)	4 (6.2)	2 (7.4)	2 (5.3)	0.88
Digestive system diseases	7 (10.8)	3 (10.3)	4 (11.1)	2 (3.1)	1 (3.7)	1 (2.6)	0.45
Rheumatic diseases	15 (23.1)	9 (31)	6 (16.7)	8 (12.3)	6 (22.2)	2 (5.3)	0.29

Abbreviation: CHD, coronary heart disease.

Figure 1 Health dimensions of energy (A), pain (B), emotional reactions (C), sleep (D), social isolation (E), and physical mobility (F) in patients with CHD before (0) and 6 and 12 months after CABG and in the control group. Values shown are mean ± SD. *P<0.05, **P<0.01, ***P<0.001 versus controls; ⁺P<0.05, ⁺⁺P<0.001, ⁺⁺⁺P<0.001 versus men; ^!P<0.05, ^!!P<0.001 versus 0.

Abbreviations: CABG, coronary artery bypass grafting; CHD, coronary heart disease; SD, standard deviation.

Figure 2 Level of depression (A) and cognitive function (B) in patients with CHD before (0) and 6 and 12 months after CABG and in the control group. Values are shown as the mean ± SD. *P<0.05, **P<0.001 versus controls; ⁺P<0.05, ⁺⁺P<0.001 versus men; ^!P<0.001 versus 0.

Abbreviations: CABG, coronary artery bypass grafting; CHD, coronary heart disease; SD, standard deviation.

Figure 3 Value of basic (ADL) (A) and instrumental (IADL) (B) activities of daily living in patients with CHD before (0) and after 6 and 12 months from CABG and in the control group. Values are shown as the mean ± SD. ⁺P<0.05, ⁺⁺P<0.001 versus controls; ⁺P<0.05, ⁺⁺P<0.001 versus men; ^!P<0.05, ^!!P<0.001 versus 0.

Abbreviations: ADL, Basic Activities of Daily Living scale; CABG, coronary artery bypass grafting; CHD, coronary heart disease; IADL, Instrumental Activities of Daily Living scale; SD, standard deviation.

Table 4 Correlation coefficients between domains of QoL and level of depression and cognitive function and performing basic and instrumental activities of daily living in patients with CHD before and after CABG

Quality of life domain	BDI			MMSE			ADL			IADL
	Pre-CABG	Post 6 months	Post 12 months	Pre-CABG	Post 6 months	Post 12 months	Pre-CABG	Post 6 months	Post 12 months	Pre-CABG	Post 6 months	Post 12 months
Energy
M	0.49†	0.77‡	0.68‡	−0.10	−0.18	0.08	−0.55‡	−0.40†	−0.21	−0.63‡	−0.17	0.01
F	0.50†	0.60‡	0.64‡	−0.11	0.21	−0.32	−0.71‡	−0.42*	−0.42*	−0.52†	−0.35	−0.42*
Pain
M	0.53‡	0.72‡	0.65‡	0.02	−0.05	0.09	−0.34*	−0.37*	−0.29	−0.22	−0.37*	0.05
F	0.34	0.47†	0.52†	0.04	−0.02	−0.25	−0.37*	−0.50†	−0.29	−0.45*	0.06	−0.32
Emotional reaction
M	0.76‡	0.71‡	0.82‡	0.01	−0.19	0.21	−0.59‡	−0.13	−0.08	−0.59‡	−0.19	0.14
F	0.50†	0.53†	0.53†	−0.16	0.25	−0.50†	−0.69‡	−0.67‡	−0.46†	−0.32	−0.26	−0.18
Sleep
M	0.48†	0.35*	0.52‡	−0.23	−0.01	−0.19	0.53‡	−0.19	−0.08	−0.48†	−0.01	−0.10
F	0.44*	0.34	0.24	−0.17	0.02	−0.39*	−0.44*	−0.52†	−0.29	−0.43*	0.04	0.02
Social isolation
M	0.54‡	0.76‡	0.49†	0.11	−0.36*	0.12	−0.48†	−0.27	−0.02	−0.33*	−0.06	0.19
F	0.26	0.38*	0.16	0.01	−0.13	−0.50†	−0.35	−0.59‡	−0.20	−0.45*	0.07	0.01
Physical mobility
M	0.25	0.60‡	0.68‡	−0.16	0.00	0.17	–0.51†	−0.50†	−0.19	−0.47†	−0.10	0.05
F	0.34	0.60‡	0.67‡	−0.23	0.01	−0.47†	−0.57‡	−0.69‡	−0.68‡	−0.61‡	−0.30	−0.32

Notes:

* P<0.05

† P<0.01

‡ P<0.001.

Abbreviations: CABG, coronary artery bypass grafting; CHD, coronary heart disease; M, male; F, female; BDI, Beck Depression Inventory; MMSE, Mini-Mental State Examination; ADL, Activities of Daily Living; IADL, Instrumental Activities of Daily Living; QoL, quality of life; SD, standard deviation.