Minimal clinically important differences in patient-reported outcomes after coronary artery bypass surgery in the arterial revascularization trial.
Eur J Cardiothorac Surg
; 66(1)2024 Jul 01.
Article
in En
| MEDLINE
| ID: mdl-38845077
ABSTRACT
OBJECTIVES:
This article identifies minimal clinically important differences (MCIDs) in quality of life (QoL) measures among patients who had coronary artery bypass grafting (CABG) and were enrolled in the arterial revascularization trial (ART). METHODS ANDRESULTS:
The European Quality of Life-5 Dimensions (EQ-5D) and the Short Form Health Survey 36-Item (SF-36) physical component (PC) and mental component (MC) scores were recorded at baseline, 5 years and 10 years in ART. The MCIDs were calculated as changes in QoL scores anchored to 1-class improvement in the New York Heart Association functional class and Canadian Cardiovascular Society scale at 5 years. Cox proportional hazard models were used to evaluate associations between MCIDs and mortality. Patient cohorts were examined for the SF-36 PC (N = 2671), SF-36 MC (N = 2815) and EQ-5D (N = 2943) measures, respectively. All QoL scores significantly improved after CABG compared to baseline. When anchored to the New York Heart Association, the MCID at 5 years was 17 (95% confidence interval 17-20) for SF-36 PC, 14 (14-17) for the SF-36 MC and 0.12 (0.12-0.15) for EQ-5D. Using the Canadian Cardiovascular Society scale as an anchor, the MCID at 5 years was 15 (15-17) for the SF-36 PC, 12 (13-15) for the SF-36 MC and 0.12 (0.11-0.14) for the EQ-5D. The MCIDs for SF-36 PC and EQ-5D at 5 years were associated with a lower risk of mortality at the 10-year follow-up point after surgery.CONCLUSIONS:
MCIDs for CABG patients have been identified. These thresholds may have direct clinical applications in monitoring patients during follow-up and in designing new trials that include QoL as a primary study outcome. CLINICAL TRIAL REGISTRATION NUMBER ISRCTN46552265.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Quality of Life
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Coronary Artery Disease
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Coronary Artery Bypass
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Patient Reported Outcome Measures
Limits:
Aged
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Female
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Humans
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Male
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Middle aged
Language:
En
Journal:
Eur J Cardiothorac Surg
/
Eur. j. cardiothorac. surg
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European journal of cardio-thoracic surgery
Journal subject:
CARDIOLOGIA
Year:
2024
Document type:
Article
Affiliation country:
Country of publication: