Inflammation, functional status changes, weight loss and quality of life of elderly patients undergoing coronary artery bypass graft surgery

ABSTRACT The aim of this descriptive study was to investigate of the inflammation, functional status changes, weight loss and quality of life of patients undergoing coronary artery bypass graft surgery. The research was conducted between 13.02.2017 and 22.05.2017 at Ege University Medical Faculty Hospital Cardiovascular Surgery Department. The sample of the research was constituted 64 volunteer conscious patients over 65 years old underwent coronary artery bypass surgery using open heart surgery technique between 13.05.2017-22.05.2017 in Ege University Medical Faculty Hospital Cardiovascular Surgery Clinic. Data were collected in an appropriate time at the time of admission to the hospital for surgery and six weeks later surgery using face to face technique. The questionnaire form was consisted of five sections under the headings of socio-demographics, medical condition, inflammation, weight loss and quality of life. Data were analysed using the SPSS for Windows 20.0 package program. It was used descriptive statistics, Student's t test for intergroup comparisons of normal distribution parameters. Wilcoxon Rank sum test and correlation analysis were used for the comparison of the non-normal distribution parameters. At the end of the study, the pre-operative C-Reactive Protein (CRP) value median of the patients was 1.93, the interquartile range was 5.73 (min=0.04, max=24.82) mg/dl at the end of the study whereas the median at the postoperative 8 weeks was 6.66 and the interquartile range was 18.22 (min=0.08, max=34.52) mg/dl. The pre-operative procalcitonin value median of the patients was 0.37, the interquartile range was 0.79 (min=0.02, max=34.57) pg/dl whereas the median at the postoperative 8 weeks was 0.66 and the interquartile range was 0.51 (min=0.04, max=31.89) pg/dl. The preoperative leukocyte median was 14.4, the interquartile range was 12.77 (min=4.22, max=21.85) 10^3/µL whereas the median at the postoperative 8 weeks was 10.15 and the interquartile range was 3.88 (min=3.09, max=86.80) 10^3/µL. The preoperative neutrophil value median was 69.35, the interquartile range was 21.55 (min=4.16, max=90.90) g/dl whereas the median at the postoperative 8 weeks was 76.0 and the interquartile range was 19.75 (min=0.45, max=90.10) g/dl. The preoperative lymphocyte median was 17.15, the interquartile range was 19.63 (min=1.12, max=45.90) g/dl, whereas the median at the postoperative 8 weeks was 14.40 and the interquartile range was 12.77 (min=1, max=38.80) g/dl. The preoperative daily living activities (ADL) median was 18 score, the interquartile range was 0 (min=16, max=18), whereas the median at the postoperative 8 weeks was 17 and the interquartile range was 2 (min=12, max=18) score. The preoperative Instrumental activities of daily living (IADL) median was 21 score, the interquartile range was 3 (min=13, max=24) score whereas the median at the postoperative 8 weeks was 16 and the interquartile range was 5 (min=9, max=21) score. The average weight of the patients was 72.87±8.07 (min=57, max=95) score at the preoperative period and 71.00±7.95 (min=54, max=91) kilogram at 8 weeks following surgery. The preoperative mini-nutritional assessment test median was 24.25, the interquartile range 0.65 (min=18.50, max=28.00) score whereas the median at the postoperative 22 and the interquartile range was 4 (min=14, max=27) score. The preoperative SF-12 quality of life scale of the physical component median was 43.81, the interquartile range 7.16 (min=31.64, max=54.75) score whereas the median at the postoperative 38.77 and the interquartile range was 7.83 (min=32.89, max=51.84) score. The preoperative SF-12 quality of life scale of the mental component median was 42.25, the interquartile range 7.95 (min=31.11, max=57.37) score whereas the median at the postoperative 48.65 and the interquartile range was 9.05 (min=29.13, max=60.12) score. The patients' CRP value (z=-4.539, p=0.0001), procalcitonin value (z=-2.699, p=0.007), leucocyte value (z=-2.451, p=0.014), ADL score (z=-5.429, p=0.0001), IADL score (z=-6.964, p=0.0001), weight (t=9.56, p=0.0001), mini nutrition evaluation score (z=-6.063, p=0.0001), SF-12 quality of life scale physical component score (z=-4.247, p=0.0001), SF-12 quality of life scale mental component score (z=-4.133, p=0.0001) compared with preoperative and postoperative 8th week, there was a statistically significant difference. The patients' neutrophil values (z=-1.418, p=0.156) and lymphocyte values (z=1.416, p=0.157) compared with preoperatively and postoperatively at 8 week, there was no statistically significant difference. The elderly patients undergoing coronary artery bypass graft surgery, at 8 weeks postoperatively, inflammation markers, increased CRP, procalcitonin, neutrophil counts, leukocyte and lymphocyte levels decreased, the decrease in functional status, ıf you have a light malnutrition, losing weight and it has been found that the quality of life has decreased in connection with these. Key words: Cardiac surgery, elderly patient, inflammation, functional status, weight loss, quality of life