• J S Rumsfeld, S MaWhinney, M McCarthy, A L Shroyer, C B VillaNueva, M O'Brien, T E Moritz, W G Henderson, F L Grover, G K Sethi, and K E Hammermeister.
• Division of Cardiology, Health Sciences Center, University of Colorado, Denver, USA. John.Rumsfeld@med.va.gov
• JAMA. 1999 Apr 14; 281 (14): 1298-303.

ContextHealth-related quality of life has not been evaluated as a predictor of mortality following coronary artery bypass graft (CABG) surgery. Evaluation of health status as a mortality predictor may be useful for preoperative risk stratification.ObjectiveTo determine whether the Physical and Mental Component Summary scores from the preoperative Short-Form 36 (SF-36) health status survey predict mortality following CABG surgery after adjustment for known clinical risk variables.DesignProspective cohort study conducted between September 1992 and December 1996.SettingFourteen Veterans Affairs hospitals.PatientsOf the 3956 patients undergoing CABG surgery only and who were enrolled in the Processes, Structures, and Outcomes of Care in Cardiac Surgery study, the 2480 who completed a preoperative SF-36.Main Outcome MeasureAll-cause mortality within 180 days after surgery.ResultsA total of 117 deaths (4.7%) occurred within 180 days of CABG surgery. The Physical Component Summary of the preoperative SF-36 was a statistically significant risk factor for 6-month mortality after adjustment for known clinical risk factors for mortality following CABG surgery. In multivariate analysis, a 10-point lower SF-36 Physical Component Summary score had an odds ratio (OR) of 1.39 (95% confidence interval [CI], 1.11-1.77; P=.006) for predicting mortality. The SF-36 Mental Component Summary score was not associated with 6-month mortality in multivariate analyses (OR, 1.09; 95% CI, 0.92-1.29; P=.31).ConclusionsThe Physical Component Summary score from the preoperative SF-36 is an independent risk factor for mortality following CABG surgery. The baseline Mental Component Summary score does not appear to be predictive of mortality. Preoperative patient self-report of the physical component of health status may be helpful for risk stratification and clinical decision making for patients undergoing CABG surgery.

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