Predictors of enhanced well-being after coronary artery bypass surgery.

OBJECTIVES

To assess patients' perception of the therapeutic outcome after coronary artery bypass surgery, and to find predictors for increased well-being.

DESIGN

Self-administered questionnaires (Family APGAR and GHQ-30) were completed on admission and at the follow-up after 12 months, together with functional classification according to the NYHA index.

SETTING

Ullevål University Hospital, Oslo, Norway, 1990-1992.

SUBJECTS

Two hundred and thirteen patients with stable angina admitted for elective coronary artery bypass surgery.

INTERVENTION

Elective coronary artery bypass surgery.

MAIN OUTCOME MEASURES

Improved physical and psychosocial functioning after one year.

RESULTS

One hundred and ninety-seven (92%) patients improved their NYHA class, while it remained stable or declined in 16 (8%) patients. Significantly fewer patients with mental distress were found at the follow-up than at the baseline examination (49 patients [23%] versus 80 patients [38%], respectively, P < 0.0001). One hundred and forty-six patients (69%) reported enhanced psychosocial well-being, while it was reduced (n = 60) or unchanged (n = 7) in 67 patients (31%). Predictors for improved psychosocial well-being following coronary artery bypass surgery were mental distress before surgery (odds ratio 2.8) and being a male patient (odds ratio 2.8).

CONCLUSIONS

The majority of the patients reported significant improvement in their physical and psychosocial functioning one year after coronary artery bypass surgery. Mental distress and male sex were significant predictors of enhanced well-being. Questionnaires on psychosocial well-being such as the GHQ-30 may, in addition to health status measurements, offer additional useful information when coronary artery bypass surgery is considered.