Quality of life in coronary patients after coronary and valvular surgery

There are different reports regarding the characteristics of examined quality of life (QOL) in patients with combined coronary and valvular surgery. Objective was to compare the quality of life changes after isolated coronary and associated coronary and valvular surgery. From February to May 2002, we prospectively studied 243 consecutive patients, who underwent elective CABG. The Nottingham Health Profile Questionnaire part I (NHP part I) was used as a model for QOL determination. NHP part I contains 38 subjective statements divided into six sections: physical mobility (PM), social isolation (SI), emotional reaction (ER), energy (En), pain and sleep. The scores ranged from zero to 100, by adding the item weight, determined by Thurstone method of paired compares, to every positive answer. We distributed the questionnaire to all patients before and six months after CABG. Two hundred twenty six patients filled in the postoperative questionnaire. An isolated coronary heart disease was present in 218 patients (89.71%), and associated coronary and valvular disease in 25 patients (10.29%). Preoperatively, there is no difference in QOL among the examined groups. After operation, quality of life was improved in 84.65% (171/202) of patients using coronary surgery and in 79.17% (19/24) of patients using combined (coronary and valvular) surgery. Quality of life was statistically improved in the first group of patients in all sections, and in the second group of patients in 4 sections (PM, En, pain and sleep) (p<0.05). There is no significant correlation between the quality of life changes after operation and the type of surgical procedure. By univariate and multivariate logistic regression, combined procedure distinguished as the independent predictor of QOL worsening in the ER section (p=0.012, OR=3.62, 95% CI 1.32-9.92). Six months after CABG quality of life was significant better in most of patients in both studied groups. Associated coronary and valvular surgical intervention distinguished as the independent predictor of quality of life worsening in the ER section.