Abstract 18727: Predictors of Health-related Quality of Life after Isolated CABG Surgery

Introduction: The purpose of this study was to determine which factors were important in predicting HRQL scores at 6 months after isolated CABG surgery. Methods: Study includes patients who had isolated CABG from Sept 2005 to Sept 2014 and completed HRQL surveys (SF-12) before and 6 months postsurgery ( N =818). Patients were categorized into 3 groups given 6 month course of General Health (GH) scores: decreased ( n =153), no change ( n =351), increased ( n =314). Multivariate linear regressions were used to examine predictors for 6 month HRQL adjusting for baseline HRQL. Results: Baseline and 6 month scores on 10 SF-12 subscales are shown (FIGURE). Patients with no change or decreased GH had higher presurgery HRQL, but at 6 months, those with increased GH had the highest HRQL. In univariate analyses, lower operative risk (EuroSCORE II) presurgery correlated with greater GH ( P <0.001) and physical composite score (PCS; P <0.001) improvement from before to 6 months after surgery. Independent predictors for greater GH at 6 months were: no peripheral vascular disease ( P =0.029), no lung disease ( P =0.001), no MI history ( P =0.001), no blood product transfusion ( P =0.027), and shorter LOS ( P =0.004). Independent predictors for greater PCS at 6 months were: younger age ( P =0.002), no lung disease ( P <0.001), no MI history ( P =0.001), no diabetes ( P =0.005), no blood transfusion ( P =0.001), and shorter LOS ( P =0.002). Predictors for greater mental composite score at 6 months were older age ( P <0.001) and no lung disease ( P =0.003). Conclusions: Even patients who present with lower HRQL can see significant HRQL improvement after surgery. Comorbid conditions present before surgery impacted HRQL postsurgery and should be managed to minimize effects on HRQL improvements. Blood transfusion was associated with lower HRQL. Given previous literature on negative implications of blood transfusion after cardiac surgery and these results, more conservative blood transfusion protocols are warranted.