The Significance of Sociodemographic Factors for Health-Related Quality of Life after Coronary Bypass Surgery

Background: Coronary artery bypass grafting (CABG) aims at prevention of myocardial infarction, relief from angina and dyspnea, and thereby improvement of health-related quality of life (HRQoL). To achieve a beneficial impact especially on the long-term outcome, it is crucial to early identify CABG patients at risk of impaired HRQoL. The present study was designed to determine preoperative risk factors for reduced postoperative HRQoL in a large cohort of consecutive isolated CABG patients. In particular, the significance of socio-demographic variables in comparison to medical characteristics was evaluated.

Method: A total number of 8,202 patients undergoing isolated CABG from January 2004 to December 2014 were prospectively contacted 6 months after the operation for a follow-up survey including the Nottingham Health Profile (NHP) as a standardized assessment tool for HRQoL. Due to death and nonresponders, 3,237 patients were finally evaluated. Data of the six domains of the NHP and further information on the preoperative sociodemographic (pre-SOC) and medical (pre-MED) variables as well as 6-month follow-up (FU) data were collected and analyzed. To reveal independent predictors of HRQoL, multivariable statistics were conducted by pre-SOC, pre-MED and FU variables consecutively entering a hierarchical regression analysis with the normalized NHP score as dependent variable.

Results: All pre-SOC (gender, age, family, and occupation status) and 6 months FU (chest pain, dyspnea) variables proved significant influence on HRQoL (p < 0.001), whereas male patients aged below 60 years were particularly impaired (p < 0.001). The effects of marriage and occupation on HRQoL are modulated by age and gender. The significance of the predictors of reduced HRQoL differs between the six NHP domains. Multivariable regression analyses revealed explained proportions of variance amounting to 7% for pre-SOC and 4% for pre-MED.

Conclusion: The identification of patients at risk of impaired postoperative HRQoL is decisive to provide additional patient-adjusted support. This study reveals that the assessment of only four preoperative sociodemographic characteristics (age, gender, marriage, and occupation) is more predictive of HRQoL after CABG than multiple medical variables.

Publication History

Article published online:
03 February 2022