Quality of life in elder adults one-year after coronary bypass

Abstract

Background: Survival rates in the elderly after cardiac surgery have improved over the last decades and therewith more attention is directed toward Quality of Life (QoL) as a patient reported outcome measure.

Objective: The purpose of this study was to explore QoL in patients one year after coronary artery bypass grafting, with special interest in the elderly patients (≥80 years).

Methods: In a quantitative, retrospective single-center study patients with isolated coronary artery bypass grafting (eg, nonvalve) surgery aged 80 years or older and operated in 2013 were included (n = 32). A control group of patients aged younger than 80 years was selected by matching based on gender and a recalculated (for age) logistic European System for Cardiac Operative Risk Evaluation (log EuroSCORE I) during the same period (n = 48). QoL assessment by the EuroQol questionnaire (EQ-5D) and additional questions were performed at one-year follow-up.

Results: QoL in elderly patients was 0.79 versus 0.90 in younger patients (P = 0.013). Overall, 54.8% of the elderly experience some or extreme problems in mobility versus 18.8% in the younger group (P = 0.001). Elderly patients also experience more problems in self care (19.3 vs 4.2%, P = 0.029). Nine of the elderly (29%) valued their postoperative health status to be worse than preoperatively versus 5 (10%) in the younger group (P = 0.028). Only patients aged 80 years or older would choose not to have surgery again (12.9%). Hospital mortality was 3.1% in the elderly group (n = 32) and 0% in the younger group (n = 48).

Conclusion: Not all elderly patients experience benefits in terms of QoL one year after cardiac surgery. Therefore, potential benefits and risks need to be considered and discussed by physicians and patients before making the decision to operate or not.