Article

Health-related quality of life following off-pump versus on-pump coronary artery bypass grafting in elderly moderate to high-risk patients: a randomized trial.

Department of Cardiothoracic Surgery, The Heart Center, Rigshospitalet, Copenhagen University Hospital, Section 9441, Blegdamsvej 9, DK-2100 Copenhagen, Denmark.
European Journal of Cardio-Thoracic Surgery (impact factor: 2.55). 09/2006; 30(2):294-9. DOI:10.1016/j.ejcts.2006.04.015 pp.294-9
Source: PubMed

ABSTRACT Previous trials comparing coronary artery bypass grafting (CABG) with or without extracorporeal circulation have mainly enrolled selected patients at younger age and low risk. Patient-reported health-related quality of life has not been significantly different. We compared health-related quality of life in elderly moderate to high-risk patients randomized to either off-pump or on-pump surgery.
The study is a sub-study of the randomized Best Bypass Surgery Trial that compares off-pump to on-pump treatment, with respect to peri- and postoperative mortality and morbidity in patients with a moderate to high-predicted preoperative risk. After randomization and before heart surgery, 120 consecutive patients were asked to fill in the Medical Outcomes Study Short Form 36 (SF-36) and Major Depression Inventory (MDI) diagnostic scale for self-report of health-related quality of life. Three months after surgery, the same questionnaires were mailed to the patients.
The response rate was 96.5%. At baseline, the groups were comparable except for a difference in educational level. Both groups improved in all eight SF-36 domains from baseline to 3 months. No statistical differences were seen between the groups except for changes in mean difference of role limitation due to emotional problems, which was significantly (P=.04) improved in favour of the on-pump group. Depression scores remained unchanged within and between the two surgical groups.
Both on-pump and off-pump patients improved in health-related quality of life scores after CABG surgery. No clinically relevant difference between the groups could be demonstrated.

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    Article: Postoperative Results of Off-Pump Coronary By-pass Grafting in Elderly Patients: A Single Center Experience.
    M Biçer, B Ozdemir, R Işçimen, D Saba, M Yanar, O Tüydeş, I Senkaya, M Cengiz
    [show abstract] [hide abstract]
    ABSTRACT: AIM: We aimed to report our postoperative results in elderly patients that had off-pump coronary bypass grafting. METHOD: Data of 173 patients with isolated coronary bypass 70 years of age or older were retrospectively evaluated. One month follow-up data were evaluated in all patients. After getting verbal informed consent a total of 91 patients were included in the quality of life assessment via EuroQoL form. The data of patients with age of 70-74 and 75 or older were compared. RESULTS: The mean ages of patients at age of 70-74 and >/=75 were 71.69+/-0.16 and 76.81+/-0.23 years; respectively. Eleven cases had in-hospital mortality (%6 of 173 patients). The mean follow-up period for the group that were reached for EuroQoL assessment was 46,3 +/- 20,8 months. The percent of cases among the whole study group that had participated in the quality of life questionnaire were in good condition in terms of mobility, self-care, usual activities, pain/discomfort, anxiety/depression were %75, %87, %81, %92 and %89; respectively. DISCUSSION: Off-pump coronary bypass operation may be safely used in elderly patients with high quality of life and low morbidity and mortality.
    The Open Cardiovascular Medicine Journal 01/2009; 3:15-20.
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    Chapter: Current Evidence of On-Pump Versus Off-Pump Coronary Artery By-Pass Surgery
    Kim Houlind
    02/2012; , ISBN: 978-953-51-0148-2
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Keywords

120 consecutive patients
 
CABG surgery
 
clinically relevant difference
 
coronary artery bypass grafting
 
eight SF-36 domains
 
elderly moderate
 
emotional problems
 
extracorporeal circulation
 
heart surgery
 
high-predicted preoperative risk
 
high-risk patients randomized
 
low risk
 
Major Depression Inventory
 
Medical Outcomes Study Short Form 36
 
off-pump patients
 
on-pump surgery
 
Patient-reported health-related quality
 
response rate
 
statistical differences
 
younger age
 

Birte Østergaard Jensen