Open heart surgery: One-year self-assessment of quality of life and functional outcome

Background. The aim of this prospective study, based on the completion of the short form health survey questionnaire (SF36) before and 1-year after open heart surgery, was threefold: to evaluate the changes in quality of life (QOL) after open heart surgery, to determine the factors influencing QOL, and to assess the relation between preoperative QOL and 1-year cardiac functional status. Methods. Logistic regression was used to determine factors that influence patients' QOL scores and their 1-year cardiac functional status. Different groups were constituted in terms of 1-year cardiac functional status by means of an arborescent classification. Results. Comparison of preoperative and postoperative mean scores in the 293 patients included in the study revealed an improvement in all but three dimensions of the SF36 scale. Quality of life improved after operation in an average of 50% of patients. The most frequently found independent predictors of impairment after surgery were NYHA functional class III or IV and angina class III or IV. At 1 year, 64% of patients had satisfactory cardiac functional status. Independent predictive factors of 1-year cardiac functional status were: physical functioning, pain, general health problems, and coronary artery bypass graft. The arborescent classification indicated that the probability of having a "satisfactory" 1-year cardiac functional status was greater than 75% for patients with at least one preoperative QOL dimension above 75 on the scale. Conclusions. Preoperative QOL determined by the SF36 is predictive of 1-year cardiac functional status. Coronary artery bypass patients do not recover as well as patients having undergone heart valve surgery. (C) 2003 by The Society of Thoracic Surgeons.