Q J Med 1999; 92: 87-96
© 1999 Association of Physicians
Patient-related outcomes five years after coronary artery bypass graft surgery
From the Departments of Cardiology, Freeman Hospital and Royal Victoria Infirmary, Newcastle upon Tyne, and 1 Division of Public Health and Primary Care, University of Oxford, Oxford, UK
Received 12 August 1998 and in revised form 11 December 1998
Dr J.S. Skinner, Ward 49 Office, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne NE1 4LP. e-mail: jane{at}enaj.demon.co.uk
For five years, we prospectively studied 353 consecutive patients undergoing first-time coronary artery bypass graft surgery (CABG) for stable angina in the North of England. Angina was present before surgery in nearly all patients, in 20% 3 months after surgery, and in 48% after 60 months. The Nottingham Health Profile, showed a significant improvement in perceived health status (PHS) 12 and 60 months after surgery compared with preoperation. However, PHS at 60 months was worse than at 12 months in the dimensions `pain' and `physical mobility' in part 1, and in `looking after the home' and `taking holidays' in part 2. Employment rates were 36%, 34% and 21%, before, and 12 and 60 months after surgery, respectively. Working at 12 and 60 months was associated with age below retirement age, work preoperation and absence of angina, and at 12 months also with male gender and waiting time <6 months. This study describes everyday clinical practice. The significant improvement in angina symptoms and PHS after CABG persists for at least 5 years. However, only one third of patients in this geographical area return to work, and this is not solely dependent on clinical symptoms.