This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (158)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in JAMA  Topic Collections  • Revascularization  • Cardiovascular System  • Quality of Life  • Surgery  • Surgical Interventions  • Cardiovascular/ Cardiothoracic Surgery  • Cardiovascular Intervention  • Alert me on articles by topic  Social Bookmarking   What's this?

John S. Rumsfeld, MD; Samantha MaWhinney, ScD; Martin McCarthy, Jr, PhD; A. Laurie W. Shroyer, PhD; Catherine B. VillaNueva, RN, MS, MBA; Maureen O'Brien, MS; Thomas E. Moritz, MS; William G. Henderson, PhD; Frederick L. Grover, MD; Gulshan K. Sethi, MD; Karl E. Hammermeister, MD; for the Participants of the Department of Veterans Affairs Cooperative Study Group on Processes, Structures, and Outcomes of Care in Cardiac Surgery

JAMA. 1999;281:1298-1303.

Context  Health-related quality of life has not been evaluated as a predictor of mortality following coronary artery bypass graft (CABG) surgery. Evaluation of health status as a mortality predictor may be useful for preoperative risk stratification.

Objective  To determine whether the Physical and Mental Component Summary scores from the preoperative Short-Form 36 (SF-36) health status survey predict mortality following CABG surgery after adjustment for known clinical risk variables.

Design  Prospective cohort study conducted between September 1992 and December 1996.

Setting  Fourteen Veterans Affairs hospitals.

Patients  Of the 3956 patients undergoing CABG surgery only and who were enrolled in the Processes, Structures, and Outcomes of Care in Cardiac Surgery study, the 2480 who completed a preoperative SF-36.

Main Outcome Measure  All-cause mortality within 180 days after surgery.

Results  A total of 117 deaths (4.7%) occurred within 180 days of CABG surgery. The Physical Component Summary of the preoperative SF-36 was a statistically significant risk factor for 6-month mortality after adjustment for known clinical risk factors for mortality following CABG surgery. In multivariate analysis, a 10-point lower SF-36 Physical Component Summary score had an odds ratio (OR) of 1.39 (95% confidence interval [CI], 1.11-1.77; P=.006) for predicting mortality. The SF-36 Mental Component Summary score was not associated with 6-month mortality in multivariate analyses (OR, 1.09; 95% CI, 0.92-1.29; P=.31).

Conclusions  The Physical Component Summary score from the preoperative SF-36 is an independent risk factor for mortality following CABG surgery. The baseline Mental Component Summary score does not appear to be predictive of mortality. Preoperative patient self-report of the physical component of health status may be helpful for risk stratification and clinical decision making for patients undergoing CABG surgery.

Author Affiliations: Division of Cardiology (Drs Rumsfeld and Hammermeister), Departments of Preventive Medicine and Biometrics (Dr MaWhinney), and Medicine (Dr Shroyer), and Division of Cardiothoracic Surgery (Dr Grover), Health Sciences Center, University of Colorado, Denver; Cardiology Section (Dr Hammermeister), Cardiac Research (Dr Shroyer and Mss VillaNueva and O'Brien), and Surgery Service (Dr Grover), Denver Veterans Affairs Medical Center, Denver, Colo; Department of Preventive Medicine, Northwestern University, Chicago, Ill (Dr McCarthy); Veterans Affairs Cooperative Studies Program Coordinating Center, Hines Veterans Affairs Medical Center, Hines, Ill (Mr Moritz and Dr Henderson); Cardiothoracic Surgery Section, Tucson Veterans Affairs Medical Center, Tucson, Ariz (Dr Sethi); and Department of Surgery, Health Sciences Center, University of Arizona, Tucson (Dr Sethi).
Principal Investigators of the Department of Veterans Affairs Cooperative Study Group on PSOCS: Marvin Kirsh, MD, Ann Arbor, Mich; Stewart Scott, MD (deceased); John Lucke, MD, Asheville, NC; John Handy, MD, Charleston, SC; David Fullerton, MD, Denver, Colo; Donald DePinto, MD, Hines, Ill; H. Gareth Tobler, MD, and Kwabena Mawulawd, MD, Little Rock, Ark; G. Hossein Almassi, MD, Milwaukee, Wis; Herbert Ward, MD, Minneapolis, Minn; Walter Merrill, MD, Nashville, Tenn; Rick Esposito, MD, New York, NY; O. LaWayne Miller, MD, San Antonio, Tex; Gulshan Sethi, MD, Tucson, Ariz; Shukri Khuri, MD, West Roxbury, Mass; and Riyad Tarazi, MD, San Diego, Calif.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLE

April 14, 1999
JAMA. 1999;281(14):1347-1348.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Trends in the Association Between Age and In-Hospital Mortality After Percutaneous Coronary Intervention: National Cardiovascular Data Registry Experience
Singh et al.
Circ Cardiovasc Interv 2009;2:20-26.
ABSTRACT | FULL TEXT  

Early and Late Outcomes of Cardiac Surgery in Octogenarians
Zingone et al.
Ann. Thorac. Surg. 2009;87:71-78.
ABSTRACT | FULL TEXT  

Predictors of Quality of Life in Hospitalized Cardiac Patients
Bruscia et al.
J Health Psychol 2008;13:982-987.
ABSTRACT  

Prospective Change in Health-Related Quality of Life and Subsequent Mortality Among Middle-Aged and Older Women
Kroenke et al.
AJPH 2008;98:2085-2091.
ABSTRACT | FULL TEXT  

Frailty and Its Potential Relevance to Cardiovascular Care
Singh et al.
Mayo Clin Proc. 2008;83:1146-1153.
ABSTRACT | FULL TEXT  

Socioeconomic status and comorbidity as predictors of preoperative quality of life in cardiac surgery
Koch et al.
J. Thorac. Cardiovasc. Surg. 2008;136:665-672.
ABSTRACT | FULL TEXT  

Health-Related Quality of Life After Cardiac Surgery
Gorman Koch et al.
SEMIN CARDIOTHORAC VASC ANESTH 2008;12:203-217.
ABSTRACT  

The Role of Postoperative Neurocognitive Dysfunction on Quality of Life for Postmenopausal Women 6 Months After Cardiac Surgery
Hogue et al.
Anesth. Analg. 2008;107:21-28.
ABSTRACT | FULL TEXT  

Prediction of Mortality in Type 2 Diabetes From Health-Related Quality of Life (ZODIAC-4)
Kleefstra et al.
Diabetes Care 2008;31:932-933.
ABSTRACT | FULL TEXT  

Invited Commentary
Ross
Ann. Thorac. Surg. 2008;85:1301-1302.
FULL TEXT  

Health related quality of life following cardiac surgery correlation with EuroSCORE
Colak et al.
Eur. J. Cardiothorac. Surg. 2008;33:72-76.
ABSTRACT | FULL TEXT  

Risk Stratification and Comorbidity
Ferraris et al.
Card Surg Adult 2008;3:199-246.
FULL TEXT  

Preoperative Evaluation for Cardiac Surgery
Albert et al.
Card Surg Adult 2008;3:261-280.
FULL TEXT  

Poor Health-Related Quality of Life Is a Predictor of Early, But Not Late, Cardiac Events After Percutaneous Coronary Intervention
Pedersen et al.
Psychosomatics 2007;48:331-337.
ABSTRACT | FULL TEXT  

Type-D Personality and Ankle Brachial Index as Predictors of Impaired Quality of Life and Depressive Symptoms in Peripheral Arterial Disease
Aquarius et al.
Arch Surg 2007;142:662-667.
ABSTRACT | FULL TEXT  

Improved Health-Related Quality of Life and Functional Status After Surgical Ventricular Restoration
Sartipy et al.
Ann. Thorac. Surg. 2007;83:1381-1387.
ABSTRACT | FULL TEXT  

The additional value of patient-reported health status in predicting 1-year mortality after invasive coronary procedures: a report from the Euro Heart Survey on Coronary Revascularisation
Lenzen et al.
Heart 2007;93:339-344.
ABSTRACT | FULL TEXT  

Effect of Functional Health-Related Quality of Life on Long-Term Survival After Cardiac Surgery
Koch et al.
Circulation 2007;115:692-699.
ABSTRACT | FULL TEXT  

Essential Features of a Surveillance System to Support the Prevention and Management of Heart Disease and Stroke: A Scientific Statement From the American Heart Association Councils on Epidemiology and Prevention, Stroke, and Cardiovascular Nursing and the Interdisciplinary Working Groups on Quality of Care and Outcomes Research and Atherosclerotic Peripheral Vascular Disease
Goff et al.
Circulation 2007;115:127-155.
FULL TEXT  

Health-Related Quality of Life Outcome After On-Pump Versus Off-Pump Coronary Artery Bypass Graft Surgery: A Prospective Randomized Study
Motallebzadeh et al.
Ann. Thorac. Surg. 2006;82:615-619.
ABSTRACT | FULL TEXT  

Gender analysis after elective open heart surgery: a two-year comparative study of quality of life.
Falcoz et al.
Ann. Thorac. Surg. 2006;81:1637-1643.
ABSTRACT | FULL TEXT  

Association of Neurocognitive Function and Quality of Life 1 Year After Coronary Artery Bypass Graft (CABG) Surgery
Phillips-Bute et al.
Psychosom. Med. 2006;68:369-375.
ABSTRACT | FULL TEXT  

Predictors of poor mid-term health related quality of life after primary isolated coronary artery bypass grafting surgery
Al-Ruzzeh et al.
Heart 2005;91:1557-1562.
ABSTRACT | FULL TEXT  

Hemodynamic Effects of Osteopathic Manipulative Treatment Immediately After Coronary Artery Bypass Graft Surgery
O-Yurvati et al.
JAOA: Journal of the American Osteopathic Association 2005;105:475-481.
ABSTRACT | FULL TEXT  

Report of the National Heart, Lung, and Blood Institute Working Group on Outcomes Research in Cardiovascular Disease
Krumholz et al.
Circulation 2005;111:3158-3166.
ABSTRACT | FULL TEXT  

Patients With Depressive Symptoms Have Lower Health Status Benefits After Coronary Artery Bypass Surgery
Mallik et al.
Circulation 2005;111:271-277.
ABSTRACT | FULL TEXT  

Predictors of the onset of depressive symptoms in patients with heart failure
Havranek et al.
J Am Coll Cardiol 2004;44:2333-2338.
ABSTRACT | FULL TEXT  

Using Health-Related Quality of Life Measures to Predict Cardiac Function in Survivors Exposed to Anthracyclines
Ginsberg et al.
JCO 2004;22:3149-3155.
ABSTRACT | FULL TEXT  

Quality of life after aortic valve replacement with tissue and mechanical implants
Sedrakyan et al.
J. Thorac. Cardiovasc. Surg. 2004;128:266-272.
ABSTRACT | FULL TEXT  

Health-related quality of life after coronary artery bypass grafting: A gender analysis using the Duke Activity Status Index
Koch et al.
J. Thorac. Cardiovasc. Surg. 2004;128:284-295.
ABSTRACT | FULL TEXT  

Enhancing Postoperative Recovery of Cardiac Surgery Patients: A Randomized Clinical Trial of an Advanced Practice Nursing Intervention
Tranmer and Parry
West J Nurs Res 2004;26:515-532.
ABSTRACT  

Changes in Body Mass Index and Late Postoperative Outcomes in Elderly Coronary Artery Bypass Grafting Patients: A Follow-up Study
DiMaria-Ghalili
Biol Res Nurs 2004;6:24-36.
ABSTRACT  

Burden of Medical Illness in Women With Depression and Posttraumatic Stress Disorder
Frayne et al.
Arch Intern Med 2004;164:1306-1312.
ABSTRACT | FULL TEXT  

Predictors of health-related quality of life after coronary artery bypass surgery
Rumsfeld et al.
Ann. Thorac. Surg. 2004;77:1508-1513.
ABSTRACT | FULL TEXT  

Comparison of the short form (SF)-12 health status instrument with the SF-36 in patients with coronary heart disease
Muller-Nordhorn et al.
Heart 2004;90:523-527.
ABSTRACT | FULL TEXT  

Gender Differences in Quality of Life Among Cardiac Patients
Emery et al.
Psychosom. Med. 2004;66:190-197.
ABSTRACT | FULL TEXT  

Health status and social risk correlates of extended length of stay following coronary artery bypass surgery
Johnston et al.
Ann. Thorac. Surg. 2004;77:557-562.
ABSTRACT | FULL TEXT  

Sex Differences in Health Status After Coronary Artery Bypass Surgery
Vaccarino et al.
Circulation 2003;108:2642-2647.
ABSTRACT | FULL TEXT  

Open heart surgery: one-year self-assessment of quality of life and functional outcome
Falcoz et al.
Ann. Thorac. Surg. 2003;76:1598-1604.
ABSTRACT | FULL TEXT  

Female Gender Is Associated With Impaired Quality of Life 1 Year After Coronary Artery Bypass Surgery
Phillips Bute et al.
Psychosom. Med. 2003;65:944-951.
ABSTRACT | FULL TEXT  

Age does not limit quality of life improvement in cardiac valve surgery
Sedrakyan et al.
J Am Coll Cardiol 2003;42:1208-1214.
ABSTRACT | FULL TEXT  

Valve surgery in the elderly: A question of quality (of life)?
Rumsfeld
J Am Coll Cardiol 2003;42:1215-1217.
FULL TEXT  

Depressive Symptoms and Health-Related Quality of Life: The Heart and Soul Study
Ruo et al.
JAMA 2003;290:215-221.
ABSTRACT | FULL TEXT  

Benefit to quality of life after Off-Pump versus On-Pump coronary bypass surgery
Immer et al.
Ann. Thorac. Surg. 2003;76:27-31.
ABSTRACT | FULL TEXT  

Risk Stratification and Comorbidity
Ferraris and Ferraris
Card Surg Adult 2003;2:187-224.
FULL TEXT  

Preoperative Evaluation for Cardiac Surgery
Albert and Antman
Card Surg Adult 2003;2:235-248.
FULL TEXT  

The impact of ethnicity on outcomes following coronary artery bypass graft surgery in the Veterans Health Administration
Rumsfeld et al.
J Am Coll Cardiol 2002;40:1786-1793.
ABSTRACT | FULL TEXT  

Health Status and Clinical Practice: When Will They Meet?
Rumsfeld
Circulation 2002;106:5-7.
FULL TEXT  

Health Status Predicts Long-Term Outcome in Outpatients With Coronary Disease
Spertus et al.
Circulation 2002;106:43-49.
ABSTRACT | FULL TEXT  

What Happens to Patients Undergoing Lung Cancer Surgery?* : Outcomes and Quality of Life Before and After Surgery
Handy et al.
Chest 2002;122:21-30.
ABSTRACT | FULL TEXT  

Self-rating of quality of life provides additional prognostic information in heart failure. Insights into the EPICAL study
Alla et al.
Eur J Heart Fail 2002;4:337-343.
ABSTRACT | FULL TEXT  

Comparison of the Nottingham Health Profile and the 36-item health survey questionnaires in cardiac surgery
Falcoz et al.
Ann. Thorac. Surg. 2002;73:1222-1228.
ABSTRACT | FULL TEXT  

Invited commentary
Ross
Ann. Thorac. Surg. 2002;73:1228-1228.
FULL TEXT  

Effect of perioperative complications on excess mortality among women after coronary artery bypass: The Israeli Coronary Artery Bypass Graft study (ISCAB)
Zitser-Gurevich et al.
J. Thorac. Cardiovasc. Surg. 2002;123:517-524.
ABSTRACT | FULL TEXT  

Quality Improvement in Cardiac Care
Grover et al.
Arch Surg 2002;137:28-36.
ABSTRACT | FULL TEXT  

Changes in health-related quality of life following coronary artery bypass graft surgery
Rumsfeld et al.
Ann. Thorac. Surg. 2001;72:2026-2032.
ABSTRACT | FULL TEXT  

Risk factors for intermediate-term survival after coronary artery bypass grafting
Gardner et al.
Ann. Thorac. Surg. 2001;72:2033-2037.
ABSTRACT | FULL TEXT  

Report of the Substudy Assessing the Impact of Neurocognitive Function on Quality of Life 5 Years After Cardiac Surgery Editorial Comment
Newman et al.
Stroke 2001;32:2874-2881.
ABSTRACT | FULL TEXT  

Efficacy of single versus bilateral internal mammary artery grafting in women: a long-term study
Kurlansky et al.
Ann. Thorac. Surg. 2001;71:1949-1958.
ABSTRACT | FULL TEXT  

Depression and Self-Reported Physical Health in Patients With Coronary Disease: Mediating and Moderating Factors
Sullivan et al.
Psychosom. Med. 2001;63:248-256.
ABSTRACT | FULL TEXT  

The influence of general health status and social support on symptomatic outcome following coronary artery bypass grafting
Lindsay et al.
Heart 2001;85:80-86.
ABSTRACT | FULL TEXT  

Assessment of changes in general health status using the short-form 36 questionnaire 1 year following coronary artery bypass grafting
Lindsay et al.
Eur. J. Cardiothorac. Surg. 2000;18:557-564.
ABSTRACT | FULL TEXT  

Other Articles Noted
Evid. Based Nurs. 1999;2:105-112.
FULL TEXT  

Quality of Life Before CABG Predicts Postoperative Mortality
Journal Watch Cardiology 1999;1999:5-5.
FULL TEXT