Feasibility and Preliminary Efficacy of Perioperative Interventions on Quality of Life, Self-Efficacy, Length of Hospital Stay and Interleukin Levels in Patients Undergoing Coronary Artery Bypass Graft Surgery

Monika Sadlonova, MD

Massachusetts General Hospital – Fellow
SADLONOVA_MONIKA poster

Scientific Abstract

BACKGROUND Coronary artery disease (CAD) is one of the leading causes of death worldwide and is associated with greater disability and impaired health-related quality of life (HRQoL). Coronary artery bypass graft (CABG) surgery is the ´gold standard´ treatment for certain types of CAD. Individuals undergoing CABG are exposed to multiple treatment-related stressors, which can impact HRQoL and post-operative recovery.

METHODS The I-COPE study (“Intervention for CABG to Optimize Patient Experience”) is a three-arm, randomized-controlled pilot trial investigating the feasibility and preliminary efficacy of perioperative interventions on HRQoL, length of hospital stay, self-efficacy, and plasma levels of interleukin(IL)-6 and -8 in CABG patients. Standard medical care (SMC, n=29) was compared with two interventions: (a) a psychological intervention to optimize treatment expectations (IA, n = 30), and (b) a multi-component intervention (IB, n = 29) consisting of the psychological intervention focused on treatment expectations (IA) plus an additional treatment package (light therapy, noise reduction, music, and if desired, 360° images delivered via virtual reality).

RESULTS We analyzed 88 patients scheduled for elective CABG. The psychological intervention was feasible (>90% of participants completed all sessions) and could easily be implemented in routine medical care in heart surgery. Duration of hospital stay (SMC: M = 12.48, IA: M = 9.83, IB: M = 9.31) was significantly shorter compared to SMC in both IA (B = -2.65, 95%CI = [-5.18;-0.51], p =.028) and IB (B = -3.18, 95%CI = [-5.79;-0.95], p =.012). Additionally, compared to SMC, self-efficacy expectations at post-surgery were significantly higher in IA (p =.011) and, marginally, in IB (p=.051). Finally, there were no treatment effects of the interventions on HRQoL and plasma levels of IL-6 or IL-8 up to 6 months after CABG.

CONCLUSIONS In addition to SMC, perioperative multi-component interventions improve healthcare utilization and self-efficacy after CABG. Further studies are needed to determine the impact of these programs on HRQoL and inflammatory response (plasma levels of IL-6 and IL-8).

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research Areas

Authors

Monika Sadlonova, MD, Christoph Herrmann-Lingen, MD, Svenja Becker, Sophie Neumann, Christopher Celano, MD, Jeff Huffman, MD, Stella Fangauf, PhD, Julia Staab, PhD, Thomas Meyer, MD, PhD, Ingo Kutschka, MD, Martin Friedrich, MD, Jonas Nagel, PhD

Principal Investigator

Jeff Huffman, MD

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