Publications [#270866] of James A. Blumenthal
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Phillips Bute, B; Mathew, J; Blumenthal, JA; Welsh-Bohmer, K; White, WD; Mark, D; Landolfo, K; Newman, MF (2003). Female gender is associated with impaired quality of life 1 year after coronary artery bypass surgery.. Psychosom Med, 65(6), 944-951. [14645771], [doi]
(last updated on 2019/07/15)
OBJECTIVE: To evaluate gender-related differences in quality of life (QOL) and cognitive function 1 year after coronary artery bypass surgery (CABG) after adjusting for known baseline differences. MATERIALS AND METHODS: Two hundred eighty patients (96 women and 184 men) underwent neurocognitive and QOL evaluation at baseline (preoperatively) and at 1 year after CABG. Multivariable linear regression was used to assess the relationship of gender to follow-up QOL and cognitive function. Measures used to evaluate QOL were IADL, DASI, work activities (SF-36), social activities, social support, general health perception (SF-36), CESD, STAI, and symptom limitations. Cognitive function was measured with a battery of performance-based neuropsychological tests, reduced to a four-cognitive domain scores with factor analysis, and a self-report measure of cognitive difficulties. Covariates in multiple regression models included age, years of education, marital status, Charlson Comorbidity Index, hypertension, diabetes, race, and baseline QOL/cognitive status. RESULTS: Female patients showed significantly worse outcome than male patients at 1 year follow-up in several key areas of QOL. After adjusting for baseline differences, women are at greater risk for increased cognitive difficulties (p= 0.04) and anxiety (p= 0.03), as well as impaired DASI (p= 0.02), IADL (p= 0.03), and work activities (p= 0.02). Cognitive sequelae attributable to bypass surgery were similar between men and women. CONCLUSIONS: Even after adjusting for known risk factors for compromised QOL and cognitive functioning, women do not show the same long-term quality benefits of CABG surgery that men do.