O-01 Health, survival and quality of life after coronary artery bypass grafting: A ten year follow-up study

Introduction The study objective was to determine the effect of coronary artery bypass grafting (CABG) on survival and long term quality of life. Method Perioperative questionnaire data were collected from eighty patients (mean age 62.4 years; 67 male, 13 female) who underwent on-pump CABG between September 1999 and June 2000. Information was gathered on mortality, disease specific symptoms (chest pain (CCS), breathlessness (NYHA), myocardial infarctions, heart failure), patient satisfaction, health related quality of life (shortform-12), functional status (Barthel's Score, Duke Activity Score, working hours) and neurocognitive function (mini mental score, strokes). Follow-up data were obtained via telephone interview at set intervals from 6 weeks to 10 years postoperatively. Analysis was basic descriptive, Mann-Whitney U, Pearson's correlation and Wilcoxon matched pairs tests using SPSS 16. Results Survival at 5 years was 91.3% and 70% at ten years. Cardiac health was improved following CABG with just 5 patients having an MI in the following 10 years. There was a significant and sustained reduction in both the prevalence of angina (97.5% pre-CABG versus 14% of survivors at ten years (p<0.001)) and also severity (reduction in mean CCS scores from 2.46 pre-CABG to <1 postoperatively (p<0.001)). Although cardiac mortality was the single most common cause it accounted for just 7/19 known causes of death. At 10 years, 17.5% of patients had had a stroke, causing 4 deaths. Other causes of death by 10 years were: cancer (5), respiratory (2) and old age (1); cause is unknown for 5 patients. Patients experienced an improved functional status (p<0.05) and cognitive function returned to normal within a year in all patients. SF-12 scores improved following CABG to become comparable with an age matched UK population (pre-CABG scores were significantly lower than the population (p<0.001)). Patients who restarted smoking did not show a sustained improvement in functional status or SF-12 score and had a more variable MMSS compared with non-smokers. Conclusion Survival and quality of life are improved by coronary artery bypass grafting but not in patients who restart smoking.