An investigation into the impact of postoperative complications on long-term quality of life (QoL) and survival following coronary artery bypass grafting (CABG) has found that, despite constant deterioration, both patients with and without complications showed improvements even 12 years after CABG compared with preoperative state.
Findings of the study were published by Matti Hokkanen (Department of Cardio-Thoracic Surgery, Tays Heart Hospital, Tampere University Hospital, Tampere, Finland) and colleagues, after they prospectively collected data from 508 patients who underwent isolated CABG.
The study team used the RAND-36 Health Survey to evaluate patients’ QoL status preoperatively, and one and 12 years after surgery. QoL and survival analyses were performed primarily on three patient groups: patients with and without complications, and patients with major adverse cardiac and cerebrovascular events (MACCE).
According to Hokkanen et al, despite steady improvements in survival and operative safety, postoperative complications after CABG still remain a significant cause of morbidity and mortality. However, they note, less is known on the impact of postoperative complications on health-related QoL.
Of the 508 patients studied, 205 (40%) had at least one postoperative complication and 73 (14%) experienced MACCE. The study team reports that 30-day, one-year and 10-year survival rates for patients without complications were 99%, 98% and 84% respectively; 97%, 95% and 72% respectively for those who did experience complications, and; 90%, 89% and 64% respectively among patients with MACCE.
The authors add that patients without complications showed significant improvements (p<0.05) in patients with 7/8 RAND-36 QoL dimensions and patients with 5/8 RAND-36 QoL dimensions. “All patient groups showed significant improvements in RAND-36 summary scores compared with preoperative values,” they state. Furthermore, the study team notes that patients with complications, and especially with MACCE, had a more profound decline in their RAND-36 summary scores, while patients without complications maintained their health status best.
In conclusion, the study’s authors write that despite ongoing decline 12 years after CABG surgery, both patients with and without complications showed steady improvements in their health-related QoL when compared with preoperative scores. “However, the patients with complications and especially with MACCE had lower postoperative QoL at one year and 12 years after the surgery,” they note. “Due to far-reaching impact of postoperative complications on patients’ QoL status, a special focus should be directed towards complication prevention and intensive rehabilitation of patients with postoperative complications after CABG surgery.”