Quality of Life Three Months After Coronary Artery Bypass Surgery: Effects of Presurgical Physical Fitness
Bass, Ila Kristen III
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Coronary artery bypass grafting (CABG) is a procedure used to help improve and save the lives of thousands of coronary artery diseased patients every year. Measuring health-related quality of life (HRQL) significantly contributes to understanding patient perceptions of outcomes attributable to this surgery. Previous research on patient outcomes for CABG has included the evaluation of changes in HRQL at intervals of 3-6 mo postsurgery. There is a lack of research, however, that evaluates how physical fitness levels of CABG patients prior to surgery, may affect these HRQL outcomes. The purpose of this study was to develop a prediction equation, using fitness in addition to other combined variables, that predicts HRQL 3 mo after CABG. This study evaluated the influences of prior physical fitness, when these attributes are considered in combination with other clinical variables. Moreover, whether these variables would be possible predictors of health-related quality of life outcomes 3 mo after CABG were evaluated. These variables consisted of heart disease risk factors, physical fitness measures, and whether or not the patients had histories of various comorbid conditions, including that of prior history of myocardial infarction. The HRQL was assessed using the Medical Outcomes Study Short Form 36 (MOS SF-36), and concurrently, questionnaire data were collected with several other patient perceived measures expected to have potential confounding influences on HRQL; the MOS Social Support Scale; Beck Depression Inventory; Health Complaints Scale; the Life Orientation Test for optimism/pessimism. In all, 45 men and 10 women, were evaluated just prior to and 3 mo following CABG. Two of the eight subscales of the MOS SF-36 were predicted at an adjusted R 2 of greater than 50%. The sum of three skinfolds was the only physical fitness measure combined with current smoker, Beck Depression Inventory, presurgical General Health Perception and the Medical Outcomes Study Social Support Scale, that contributed most to predicting General Health Perception (R 2 =.68). Elbow flexion was the only physical fitness variable, combined with four presurgical MOS SF-36 subscales (Mental Health, Role Physical, Social Functioning and General Health Perception) that contributed to predicting the subscale of mental health (R 2 =.61). Physical fitness did contribute to predicting the global scope of health perception and mental health. Physical and social domains of HRQL, however, were not significantly predicted. Presurgical HRQL was most significant when predicting postsurgical HRQL. Therefore, in order to predict postsurgical HRQL, presurgical HRQL should be used. Physical fitness variables can be utilized to contribute to predicting certain aspects of HRQL.
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