Background
Materials and methods
Design
Population
Clinical characteristics and data collection
Outcomes
Procedures
Statistical analysis
Results
Study population
Patient characteristics and outcome
N = 658 | |
---|---|
Age (years) | 65.5 ± 9.0 |
Male gender | 542 (82.4%) |
Current smoking | 191 (29.0%) |
Body mass index (kg/m2) | 26.8 (24.6–29.8) |
Hypertension | 338 (51.4%) |
Myocardial infarction | 75 (11.4%) |
Stroke | 54 (8.2%) |
Pulmonary disease | 50 (7.6%) |
Atrial fibrillation | 26 (4.0%) |
Peripheral vascular disease | 68 (10.3%) |
Unstable angina | 65 (9.9%) |
Diabetes mellitus | 133 (20.2%) |
Left ventricular ejection fraction | |
Good (≥50%) | 546 (83.0%) |
Moderate (30–50%) | 94 (14.3%) |
Poor (< 30%) | 18 (2.7%) |
Additive EuroSCORE | 3 (1–4) |
Preoperative hemoglobine (mmol/l) | 8.8 (8.2–9.3) |
Preoperative creatinine (μmol/) | 82 (73–95) |
Health related quality of life | |
Preoperative physical HRQL | 39.2 ± 5.4 39.0 (36.0–42.6) |
Preoperative mental HRQL | 48.9 ± 13.1 50.3 (40.2–59.0) |
Surgical characteristics | |
Duration of surgery (min) | 189 (163–226) |
Extra corporeal circulation time(min) | 83 (68–101) |
Mini extra corporeal circulation | 485 (73.7%) |
Use of internal mammary artery | 626 (95.1%) |
Packed red blood cell transfusiona | 54 (8.2%) |
Blood loss (ml)b | 660 (519–850) |
Determinants of a clinically relevant change in physical HRQL
Worse physical HRQL | Better physical HRQL | |||
---|---|---|---|---|
Beta | OR (95% CI) | Beta | OR (95% CI) | |
Age (per year) | −0.03 | 0.97 (0.92–1.01) | −0.00 | 1.00 (0.95–1.04) |
Body mass index (per point) | 0.02 | 1.02 (0.94–1.09) | − 0.04 | 0.96 (0.91–1.02) |
EuroSCORE (per point) | 0.16 | 1.18 (0.95–1.46) | −0.03 | 0.98 (0.81–1.18) |
LVEF > 50% | 0 | 1.00 | 0 | 0 |
LVEF 30–50% | 1.67 | 5.32 (0.41–69.61) | 0.60 | 1.82 (0.43–7.65) |
LVEF < 30% | 1.15 | 3.16 (0.25–39.56) | 0.66 | 1.94 (0.50–7.61) |
Hemoglobin (per point) | − 0.03 | 0.97 (0.65–1.44) | − 0.24 | 0.79 (0.56–1.10) |
Creatinine (per point) | − 0.01 | 0.99 (0.98–1.01) | − 0.00 | 1.00 (0.99–1.01) |
Preoperative physical HRQL (per point) | ||||
Singular | −1.25*** | 0.54 | ||
Quadratic | 0.02*** |
a
| −0.01* |
a
|
Preoperative mental HRQL (per point) | 0.00 | 1.00 (0.98–1.03) | 0.01 | 1.01 (0.99–1.03) |
Male gender | 0.07 | 1.07 (0.43–4.47) | 0.11 | 1.12 (0.52–2.41) |
Active smoking | 0.41 | 1.51 (0.79–2.88) | 0.45 | 1.57 (0.91–2.69) |
Hypertension | 0.51 | 1.67 (0.91–3.06) | − 0.04 | 0.96 (0.60–1.55) |
Myocardial infarction | 0.18 | 1.19 (0.50–2.84) | 0.37 | 1.45 (0.69–3.04) |
Stroke | 0.99* | 2.68 (1.04–6.88) | 0.47 | 1.60 (0.98–3.79) |
Pulmonary disease | 0.44 | 1.56 (0.55–4.43) | 0.86* | 2.36 (1.05–5.31) |
Atrial fibrillation | −3.17* | 0.04 (0.00–0.97) | −1.50 | 0.22 (0.05–1.10) |
Peripheral vascular disease | − 1.23* | 0.29 (0.10–0.90) | 0.20 | 1.23 (0.57–2.64) |
Unstable angina | −0.47 | 0.62 (0.24–1.63) | 0.22 | 1.25 (0.57–2.75) |
Diabetes mellitus | 0.22 | 0.25 (0.59–2.65) | −0.13 | 0.88 (0.49–1.60) |
Determinants of a clinically relevant change in mental HRQL
Worse mental HRQL | Better mental HRQL | |||
---|---|---|---|---|
Beta | OR (95% CI) | Beta | OR (95% CI) | |
Age (per year) | −0.02 | 0.98 (0.93–1.02) | 0.01 | 1.01 (0.97–1.04) |
Body mass index (per point) | 0.02 | 1.02 (0.96–1.08) | 0.01 | 1.01 (0.96–1.06) |
EuroSCORE (per point) | 0.02 | 1.02 (0.85–1.23) | −0.07 | 0.94 (0.80–1.10) |
LVEF > 50% | 0 | 0 | 0 | 0 |
LVEF 30–50% | −0.36 | 0.84 (0.21–3.39) | 1.13 | 3.09 (0.60–15.83) |
LVEF < 30% | − 0.18 | 0.70 (0.19–2.63) | 0.66 | 1.93 (0.40–9.36) |
Hemoglobin (per point) | −0.15 | 0.86 (0.61–1.23) | 0.03 | 1.07 (0.80–1.43) |
Creatinine (per point) | 0.01 | 1.01 (1.00–1.02) | −0.00 | 1.00 (0.99–1.01) |
Preoperative physical HRQL (per point) | − 0.00 | 1.00 (0.95–1.05) | 0.08*** | 1.08 (1.04–1.13) |
Preoperative mental HRQL (per point) | ||||
Singular | 0.02 | −1.07** | ||
Quadratic | −0.01 | 0.02** | ||
Cubic | 0.00 |
a
| 0.00** |
a
|
Male gender | 0.15 | 1.17 (0.52–2.61) | −0.04 | 0.96 (0.50–1.85) |
Active smoking | − 0.09 | 0.92 (0.51–1.65) | 0.03 | 1.04 (0.65–1.65) |
Hypertension | 0.16 | 1.18 (0.71–1.95) | 0.12 | 1.13 (0.75–1.71) |
Myocardial infarction | 0.20 | 1.23 (0.60–2.51) | −0.56 | 0.57 (0.29–1.11) |
Stroke | − 0.03 | 0.97 (0.37–2.50) | 0.18 | 1.19 (0.57–2.52) |
Pulmonary disease | 0.37 | 1.45 (0.63–3.34) | −0.62 | 0.54 (0.25–1.14) |
Atrial fibrillation | 0.39 | 1.48 (0.44–4.99) | −0.35 | 0.71 (0.23–2.15) |
Peripheral vascular disease | 0.00 | 1.00 (0.41–2.44) | 0.34 | 1.41 (0.72–2.77) |
Unstable angina | 0.17 | 1.12 (0.52–2.74) | 0.20 | 1.22 (0.62–2.41) |
Diabetes mellitus | − 0.6 | 0.94 (0.49–1.81) | 0.02 | 1.02 (0.60–1.74) |