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THE JOURNAL OF CARDIOVASCULAR SURGERY
Rivista di Chirurgia Cardiaca, Vascolare e Toracica
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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ORIGINAL ARTICLES CARDIAC SECTION
The Journal of Cardiovascular Surgery 2008 Ottobre;49(5):663-72
EuroSCORE predicts poor health-related physical functioning six month postcoronary artery bypass graft surgery
El Baz N. 1, Middel B. 1,5, Van Dijk J. P. 2, Wesselman D. C. M. 4, Boonstra P. W. 3, Reijneveld S. A. 2
1 University Medical Center Groningen Department of Health Sciences University of Groningen, the Netherlands
2 University Medical Center Groningen Department of Health Sciences Public Health subdivision University of Groningen, the Netherlands
3 University Medical Center Groningen, Thorax Center University of Groningen, The Netherlands
4 Thorax Center, HAGA Hospital The Hague, the Netherlands
5 University Medical Center Groningen Department of Oral Health and Clinical Epidemiology University of Groningen, The Netherlands
Aim. The objectives of this study are to test whether the European system of cardiac-operative risk evaluation score (EuroSCORE) is associated with preoperative health-related quality of life (HRQoL), and whether it is a predictor of mental and physical health-related quality of life six months after coronary artery bypass grafting (CABG).
Methods. A longitudinal observational study was carried out among 181 patients who underwent CABG. Physical and mental domains of quality of life were measured using SF-36 and risk stratification was estimated using the EuroSCORE. A post hoc test (with Bonferroni correction) was used to determine whether EuroSCORE was associated with preoperative HRQoL, LOS and postoperative rate of complications. Hierarchical regression analysis was performed to explore the associations between EuroSCORE, postoperative events and postoperative HRQoL.
Results. EuroSCORE is associated with physical functioning before and after CABG and a higher EuroSCORE is a predictor of poor physical functioning and not a predictor of the mental domains of quality of life, while smoking predicted bodily pain after CABG. Furthermore, readmission within six weeks after discharge was a predictor of poor physical functioning, physical role and general health. Moreover, post hoc tests showed statistically significant and clinically relevant differences in physical functioning between low-risk and high-risk EuroSCORE classes, and between medium and high classes at baseline and six months after CABG. High-risk patients had more perioperative complications and longer lengths of stay, as compared to low-risk patients.
Conclusion. EuroSCORE is a predictor of poor self-reported physical functioning six months after CABG and is not a predictor of mental functioning.