Age differences in patient recovery patterns following coronary artery bypass surgery

OBJECTIVE: The purpose of this study was to determine whether physical, psychological and social recovery within the first 6 weeks following coronary artery bypass surgery varied by age. METHODS: A repeated measures design was used for this study. Data were collected from a convenience sample of three age groups of patients at the following times: prior to hospital discharge and at 1, 3 and 6 weeks after discharge. The three age groups studied were less than 60 years, 60 to 70 years and more than 70 years. Data were collected by interview and mail questionnaires. The initial sample consisted of 258 patients, of whom 184 completed the study. Eleven instruments were used to measure recovery including the Sickness Impact Profile, Beck Depression Inventory, Rosenberg Self-Esteem scale and the Symptom Inventory. RESULTS: No significant differences were found among the age groups for any of the physical, psychological or social recovery measures. Within each age group physical, psychological and social recovery improved significantly over time. Although patients more than 70 years of age remained in the hospital significantly longer, once discharged, they did not have more difficulty with recovery than the other age groups. DISCUSSION: As expected, all age groups experienced significant improvement in recovery over time. CONCLUSIONS: Contrary to what past research about cardiac surgery and the elderly might lead one to expect, in this study, the oldest patients did not have the poorest recovery patterns. Persons more than 70 years had recovery patterns similar to those of younger age groups.

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Stressors and Anxiety in Patients Undergoing Coronary Artery Bypass Surgery

American Journal of Critical Care ◽

10.4037/ajcc2007.16.3.248 ◽

2007 ◽

Vol 16 (3) ◽

pp. 248-257 ◽

Cited By ~ 49

Author(s):

Robyn Gallagher ◽

Sharon McKinley

Keyword(s):

Coronary Artery ◽

Pain Management ◽

Coronary Artery Bypass ◽

Older Patients ◽

Coronary Artery Bypass Surgery ◽

Bypass Surgery ◽

Artery Bypass ◽

Anxiety Levels ◽

Realistic Information ◽

Over Time

Background Patients undergoing coronary artery bypass surgery who have increased anxiety levels have poorer outcomes than patients with lower levels, yet few studies have identified the concerns associated with this anxiety. Objective To describe the concerns of patients undergoing coronary artery bypass surgery and to identify concerns that were associated with higher levels of anxiety. Method Patients (n = 172) were interviewed to determine their concerns and anxiety levels before surgery, before discharge, and 10 days after discharge. Multiple regression was used to determine the predictors of anxiety. Results Although individual concerns changed over time, anxiety levels did not change from before to after surgery, remaining low to moderate. Being female and having more concerns about waiting for the surgery, being in pain/discomfort, and resuming lifestyle were predictors of increased anxiety before surgery. Predictors of increased anxiety while hospitalized after the surgery included taking anxiolytic or antidepressant medications, higher anxiety levels before surgery, concerns about personal things being inaccessible, and difficulty sleeping. Patients with higher anxiety levels after discharge were older, more anxious before surgery, and had concerns about being in pain/discomfort. Conclusion Patients waiting for coronary artery bypass surgery should be routinely assessed for anxiety before the procedure, and interventions to prevent or reduce anxiety should be provided. Interventions must be multifactorial, including information and support for pain management and realistic information about surgery schedules and resuming lifestyle after the surgery. Women and older patients may need to be targeted for intervention.

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Abstract 13346: The Rate of Incomplete Revascularization Following Coronary Artery Bypass Surgery Has Increased Over Time

Circulation ◽

10.1161/circ.142.suppl_3.13346 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Chase R Soukup ◽

Christian W Schmidt ◽

Carmen Chan-Tram ◽

Ross F Garberich ◽

Benjamin Sun ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Coronary Artery Bypass ◽

Coronary Artery Bypass Surgery ◽

Bypass Surgery ◽

Artery Bypass ◽

Complete Revascularization ◽

Incomplete Revascularization ◽

Artery Disease ◽

Over Time

Introduction: Incomplete revascularization following coronary artery bypass surgery (CABG) is associated with increased repeat revascularization, myocardial infarction and death. However, whether the rate of incomplete revascularization is increasing over time has not been previously described. Methods: We performed a retrospective review of consecutive patients who underwent elective and isolated CABG for multi-vessel coronary artery disease in 2007 (n=291) and in 2017 (n=290) at a single Institution. All coronary angiograms and CABG operative reports were reviewed and a Revascularization Index Score (RIS) was created to compare rates of incomplete revascularization between the two time periods based on the coronary anatomy and degree of stenosis. Thus a patient with complete revascularization will have an RIS score of 1.0 while a patient who has 3 of 4 eligible vessels bypassed will have an RIS score of 0.75. Results: Over a 10 year period, the rate of incomplete revascularization increased from 17.9% to 28.3% (p = 0.003) and was accompanied by a decline in the RIS score from 0.73 to 0.67 (p= 0.005). Mortality significantly increased over time with incomplete compared to complete revascularization in the 2007 cohort. Conclusions: The incidence of incomplete revascularization following CABG significantly increased over a 10-year time period between 2007 and 2017. These differences may be attributable to patient factors including more severe coronary artery disease associated with older age, greater incidence of smoking and previous PCI. In line with previous. meta-analyses, the incidence of mortality over time was higher in those patients with incomplete compared to those with complete revascularization. These results suggest that patients with incomplete revascularization represents an important target for the development of novel therapies.

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Subjectively perceived quality of life after coronary artery bypass surgery

American Journal of Critical Care ◽

10.4037/ajcc2001.10.1.11 ◽

2001 ◽

Vol 10 (1) ◽

pp. 11-16 ◽

Cited By ~ 15

Author(s):

AC Ross ◽

L Ostrow

Keyword(s):

Quality Of Life ◽

Coronary Artery ◽

Coronary Artery Bypass ◽

Coronary Artery Bypass Surgery ◽

Bypass Surgery ◽

Short Form ◽

Artery Bypass ◽

Well Being ◽

Over Time

BACKGROUND: Judgment of quality of life after coronary artery bypass surgery is usually based on objective measures of cardiovascular status. Quality of life cannot be determined solely objectively because such indicators do not explain how persons perceive and experience their lives. OBJECTIVES: To assess the quality of life and mood state over time in patients undergoing coronary artery bypass grafting and to improve understanding of subjective perceptions of well-being and how these perceptions change over time. METHODS: Three questionnaires, the Quality of Life Index, the Medical Outcomes Study 36-Item Short-Form Health Survey, and the Profile of Mood States, were administered at 3 different times (before surgery, 6 weeks after surgery, and 3 months after surgery) to a convenience sample of hospitalized adults undergoing coronary artery bypass surgery for treatment of coronary artery disease. RESULTS: For all 3 questionnaires, responses differed significantly over time. Mean scores were significantly different over time for total mood disturbance (P = .03), the socioeconomic domain of the Quality of Life Index (P = .02), and the physical functioning (P = .004), vitality (P = .007), and social functioning (P = .002) dimensions of the 36-item short-form survey. CONCLUSIONS: Subjective perceptions of physical and psychological well-being changed significantly from before surgery to 3 months after surgery. Measures of mood state, physical functioning, vitality, and social functioning improved significantly over time. However, satisfaction with the socioeconomic domain decreased significantly from before surgery to 3 months after surgery.

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