Will cardiac surgery improve my quality of life?: Visual analogue score as a first step in preoperative counseling.

BACKGROUND.: The intention of this study is to analyse the correlation between a visual analogue scale (VAS) and the most common preoperative comorbidity and cardiac variables in patients undergoing elective cardiac surgery. This VAS is simple, easy to register and can be used as a global measurement of quality of life (QOL). METHODS.: Preoperative assessment of QOL in 1351 patients, 979 men and 372 women, with a mean age of 64.5+/-10.5 (18-88), undergoing elective cardiac surgery between January 2003 and December 2005. QOL was measured by the EuroQol questionnaire. RESULTS.: The mean VAS was 58.7+/-20.9, range 3 to 100. Univariate analysis showed a difference for sex (p=0.000), and NYHA (p=0.009) between patients with an isolated CABG and those with a combined revascularisation (p=0.05). Stepwise logistic regression analysis identified female gender (p=0.00), NYHA (p=0.00) and valve disease (p=0.03) as independent variables for a low QOL. The correlation between NYHA and QOL was low (r=-0.09, p=0.003). CONCLUSION.: The clinical consequence is that using this simple VAS we can identify patients with a good QOL. If these patients present for high-risk surgery, with a better quality of life as primary indication, more extended counselling regarding their QOL is recommended. (Neth Heart J 2007;15:51-4.).

Physical activity post myocardial revascularization. ''Will surgery improve my mobility?

AIM: The aim of this study is to evaluate the influence of coronary artery bypass graft (CABG) on physical activity (PA) one year postoperative and the influence of the preoperative level of PA on the postoperative PA level. METHODS: In 428 patients, mean age 64.1+/-9.2 (30-84), undergoing an isolated CABG in 2003, pre and one year postoperatively PA was recorded. Preoperatively, 4 patients (0.9%) were in NYHA I, 33 (7.7%) in NYHA II, 334 (78%) in NYHA III and 57 patients (13.4%) in NYHA class IV. PA was recorded following the Honolulu Heart project. For analysis purposes PA levels were classified as sedentary, 41 patients (9.5%) or minimally active, 161 patients (37.6%) were included in a single sedentary group; 202 patients (47.1%). Patients classified as moderately active, 127 patients (29.6%), active, 72 patients (16.8%) and very active, 27 patients (6.3%) were included in a single active group, 226 patients (52.9%). RESULTS: One year postoperatively, 394 patients (92.%) indicated they were angina-free. One hundred seventy-seven patients (41.3%) recorded a better PA-level. One hundred seventy-one patients (40%) recorded the same and 80 patients (18.7%) had a lower PA level. Significantly more patients, 63.9% of the sedentary group versus 21.2% of the active group recorded a higher PA level (P=0.00). Multivariate analysis identified a preoperative active level and vascular disease as risk factors for decreased postoperative PA (P=0.00, odds ratio: 8.1) and a sedentary level as a risk factor for no increase (P=0.00, odds ratio 6.8) CONCLUSIONS: Sedentary patients are likely to show an improvement, however, a sedentary lifestyle is a predictor of no increase in PA. Patients with an active level are unlikely to benefit from surgery.