Mental health and quality of life outcomes after CABG in a South Asian country: a prospective study

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BACKGROUND: Coronary artery bypass grafting (CABG) is a proven life-saving intervention for ischemic heart disease (IHD). However, literature on its post-surgical quality of life (QoL) and mental health is limited in resource-constrained settings, where IHD burden remains high. This study determined changes in depression, anxiety, and QoL pre-operatively to 1- and 6-month post-CABG in a South Asian low- and middle-income country (LMIC). METHODS: This prospective study was conducted at a large private hospital in Pakistan (February 2022-March 2023). Data were collected pre-operatively, 1-month, and 6-month post-CABG. Beck Depression Inventory II (BDI-II), Beck Anxiety Inventory (BAI), and 36-Item Short Form Health Survey (SF-36) were used to assess depression, anxiety, and QoL, respectively. Pre-operative scores were compared with 1-month and 6-month post-operative scores using paired t-tests, with p-value < 0.05 considered significant. RESULTS: The mean age of 82 patients with complete pre-operative data was 58.48 ± 10.07 years. 1- and 6-month follow-up rates were 63% and 53.7%, respectively. No significant differences were noted for depression, but mean anxiety scores reduced preoperatively to 6-month postoperatively (7.48 ± 8.44 to 4.39 ± 7.25, p-value:0.0216). 6-month postoperative results demonstrated significant improvements from preoperative scores in physical functioning (57.39 to 81.36), role limitations due to physical health (32.39 to 69.89), role limitations due to emotional problems (58.33 to 84.09), and general health perceptions (71.36 to 81.36). CONCLUSION: This study showed improvement in anxiety and QoL 6 months after CABG. However, depression scores remained unchanged. Interventions like pre-operative counselling, post-operative cardiac rehabilitation, and long-term psychiatric evaluation are critical to support sustained recovery post-CABG.

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