eComment: Even the elderly post-CABG patients have a better HRQoL postoperatively
Journal
Interactive CardioVascular and Thoracic Surgery
Date Issued
August 4, 2008
Abstract
According to your excellent study, male patients under 75 years old and female patients under 70 years old, with good ventricular function and without other co-morbidity, might obtain the best prospect for better health-related quality of life (HRQoL) [1]. In fact, it is evident from Table 2 of your study, that while the mean age in the group of low-, and medium-risk was 59 and 69, respectively, in the high-risk group it was 75.6 years [1]. Despite this fact, clinical improvement was observed in 46.8% of low-risk patients, in 34.8% of medium-risk patients and in 33.3% of high-risk patients, respectively. However, the differences were not significant among the 3 study groups, even at 36 months. The above finding is important because several studies have reported that in elderly patients – in whom a higher comorbidity usually exists – an increased incidence of postoperative greater worry and depression has been observed [2], severe emotional problems, and therefore a worse HRQoL, at least for 12 months postoperatively [3]. Contrary to this, we have demonstrated in a small number of elderly patients (mean age 72.9) that at 12 months following the operation, 80.4% of patients experienced an improvement in their reported HRQoL, in spite of the fact that nearly one in two patients reported neuro-cognitive problems that were present at 12 months postoperatively [4]. Moreover, despite the high incidence of early postoperative complications (up to 66.6%), HRQoL was significantly improved at 4 months after the operation (P<0.001) and continued being improved to a lesser degree one year afterwards (P<0.001).