Comorbid illness affects health‑related quality of life after coronary artery bypass graft surgery

Abstract

Objective: The purpose of this study was primarily to examine patients’ health related quality of life (HRQoL) and secondarily to examine the effect of comorbid illness on HRQoL five years after coronary artery bypass graft surgery (CABGS).

Design: A prospective study using the Short‑Form 36 health survey (SF‑36) was performed.

Setting: The study was performed at a central London hospital, United Kingdom.

Subjects: From a previous study with 162 patients enrolled, one hundred and twenty‑eight (79%) agreed to participate in a follow‑up study five years after cardiac surgery by either a face‑to‑face or postal method.

Intervention: Participants were asked to complete questionnaires about their HRQoL, current illnesses and medication five years after CABGS.

Main outcome measures: Physical and mental HRQoL was recorded using a self report and the effect that comorbid illness has on
HRQoL five years post CABGS was determined.

Results: Fifty five percent of the sample reported concomitant illness at the time of follow‑up and lower scores were observed in the physical domains of the SF‑36 reflecting poorer HRQoL. The domains of physical functioning, physical role limitations, social functioning and bodily pain and the summary physical score were significantly lower in those with comorbid illness (p<0.001). Significantly higher rates of hospitalisation following CABGS were also noted. However no significant differences were observed in mental HRQoL (p=0.593) compared to those with no comorbid illness.

Conclusion: The presence of comorbid illness impacts significantly on physical HRQoL five years after CABGS but no such effect is noted in mental wellbeing. From a nursing perspective, the importance of comorbid illness should be taken into account when planning physical activities after CABGS, when educating patients about the benefits of CABGS and when setting realistic
expectations after surgery.