Objectives: To evaluate the mental state and health related quality of life (HQoL) of cardiac patients, before and 1-year after Coronary Artery Bypass Graft (CABG) Surgery.
Methods and Patients: A prospective study, conducted in 5 cardiothoracic wards throughout Israel, followed for 1-year 632 men and 189 women, operated on between February 2004 and August 2006. Pre and post-surgical levels of HQoL, depression and anxiety, were evaluated using SF-36 and HADS questionnaires.
Results: Women showed poorer levels of physical and mental HQoL than men, both pre and 1-year post-surgery, and the level of HQoL improved in men and women following surgery with a greater improvement in men. About 1/3 of all women and 1/5 of all men showed anxiety symptoms pre and post-surgery. About 1/6 of all men showed depressive symptoms at both times, yet, the proportion of women with depressive symptoms rose from 1/5 to 1/3 a year post-surgery. Women showed greater levels of anxiety and depression than men in both time points (p<0.01). The level of anxiety stayed stable in men but worsened in women after a year, and both men and women exhibited significantly higher levels of depression a year after surgery compared to their pre-surgical state. These differences persisted after adjustment for age, education, number of grafts, and time between interviews. In a multiple regression model, females were twice as likely to be in a depressive state as men (OR=1.97, p=0.004) adjusting for age, baseline depression level, income, education and co-morbidities. Predictors for anxiety 1-year after CABG surgery were age, baseline level of anxiety, lower education, and co-morbidities.
Conclusion: Although HQoL improves 1-year after CABG surgery, prevalence of anxiety and depression are high in coronary patients and do not resolve 1-year after the surgery, especially in women. The mental state of this patient population calls for attention.
