Quality of life and functional capacity in patients after cardiac surgery intensive care unit

Table 1 Characteristics of studies that evaluated patient outcomes after coronary artery bypass grafting and other cardiac surgery

Ref.	Study design	Purpose	Population (n)	Male/female; age in yr	Cardiopulmonary bypass time in min/X-clamp time in min	Intervention	Outcomes	Main results
Deschka et al[11], 2013	Observational study	To assess survival, functional capacity, and QoL 1 year after cardiac surgery	CABG, HVS, combined procedures, aortic surgery, miscellaneous, emergency procedures (119)	84/35; 72.2 ± 9.3	NA	Barthel mobility index, SF-12 questionnaire	Long-term ICU treatment after cardiac surgery is related to a high in-hospital and follow-up mortality	In-hospital: Mortality was 36.1%, 1-year overall survival was 46.2%, and 1-year survival of the discharged patients was 72.4%. Preoperative Barthel mobility index was 94.7% ± 13.9% vs 85.2% ± 23.0% postoperatively. QoL was comparable with the normative population
Peric et al[49], 2015	Observational study	To evaluate the changes in QoL 6 months after CABG surgery related to the patients’ age	CABG (226)	181/45; 58.3 ± 8.3/61.6 ± 6.1	On pump procedure	NHP questionnaire part 1 before and 6 months after surgery	Improvement of QoL after 6 months in older patients. Age is not an independent predictor of QoL deterioration after CABG	Before CABG elderly patients had worse QoL in sections of PM (r = 0.22, P = 0.001), SI (r = 0.16, P = 0.009) and En (r = 0.23, P = 0.001). After 6 months, patients group < 50 years improved in sections of PM, En, pain, and sleep. Group 60-69 years improved in all sections. Group 50-59 years and ≥ 70 years also improved in all sections except SI and sleep respectively. There was a significant relationship between patient’s age and improvement of QoL in sections of PM (r = 0.18, P = 0.008), SI (r = 0.17, P = 0.01) and En (r = 0.21, P = 0.002)
Westerdahl et al[51], 2016	Prospective study	To investigate pulmonary function and HRQoL 1 year after cardiac surgery	CABG, HVS, or combined surgery (150)	123/27; 66 ± 9	112 ± 53/84 ± 46	SF-36 questionnaire, pulmonary function measurements	HRQoL improved in comparison to preoperative values. Static and dynamic lung function measurements slightly decreased, levels of pain were low, and saturation of peripheral oxygen was same as preoperatively	HRQoL improved in all 8 aspects of SF-36 (P < 0.001). FVC decreased by 4%-5% compared to preoperative values (P < 0.05). Sternotomy-related pain at rest was 0 (0-7), at deep breath 0 (0-4) and at coughing 0 (0-8)
Gjeilo et al[12], 2018	Prospective, observational cohort study	To assess survival, functional status, and HRQoL 10 years after cardiac surgery	Isolated CABG, HVS, CABG with HVS, miscellaneous (274)	228/46; 64.1 ± 9.9	64.0 (range: 16.0-206)/40.0 (5.0-180.0)	SF-36 questionnaire NYHA classification	HRQoL and function improved from before to 10 years after cardiac surgery, also for older patients	Total survival at 10 years was 67.8%. HRQoL improved compared with baseline in 7 of 8 SF-36 subscales. Older patients improved less than younger patients (3 of 8 SF-36 subscales were worse). NYHA classification improved also among older patients (from 59% in NYHA class III/IV at baseline to 30.3% after 10 years, P < 0.013)
Joskowiak et al[39], 2022	Prospective cohort study	To assess HRQoL change within 12 months after cardiac surgery and to identify predictors of deterioration in physical and mental health	CABG, AVR, CABG and AVR, aortic surgery, other surgery, redo surgery (164)	123/41; 70 (range: 62-76)	122.9 ± 37.4/81.8 ± 27.6	SF-36 questionnaire upon admission and at 3 months and 12 months after surgery	Gradual improvement of physical and mental health status	PCS score increased from 40.1 (range: 31.9-49.9) before surgery to 46.3 (37.0-52.4) at 3 months and 52.4 (46.4-56.3) at 12 months after surgery. The MCS score increased from 48.8 (38.6-55.3) at baseline to 50.9 (38.9-57.2) at 3 months and 53.1 (42.0-57.8) at 12 months after surgery. Up to 7.9% and 21.2% of patients had poorer PCS and MCS scores respectively at 12 months. Predictors of deterioration in postoperative HRQoL are preoperative health status, age < 70 years, CABG and a previous neurological event
Muthukrishnan et al[50], 2023	Prospective cohort study	To determine the QoL 3 months after CABG surgery	CABG (200)	184/16; 55 (12.5)		SF-36 questionnaire and STAI scale 2 days before and 3 months after CABG surgery	Improvement in physical health. Preoperative anxiety was a significant predictor of physical health	PCS score was 34.57 ± 9.6 preoperative vs 43.53 ± 7 postoperative. MCS score respectively was 54.87 ± 1.19 vs 51.65 ± 9.67. Perception of low physical health QoL was due to preoperative anxiety (β = 0.535, t = 8.433, P < 0.001)

AVR: Aortic valve surgery; CABG: Coronary artery by-pass grafting; CAD: Coronary artery disease; En: Energy; FVC: Forced vital capacity; HRQoL: Health-related quality of life; HVS: Heart valve surgery; MCS: Mental component summary; NA: Not available; NYHA: New York Heart Association; PCS: Physical component summary; PM: Physical mobility; QoL: Quality of life; SI: Social isolation; STAI: State-trait anxiety inventory; SF-36: Short-Form Health Survey-36.