Relationships between fatigue and early postoperative recovery outcomes over time in elderly patients undergoing coronary artery bypass graft surgery

BACKGROUND: Despite successful coronary artery bypass graft (CABG) surgery, some patients continue to experience fatigue after their surgery. OBJECTIVE: The purpose of this secondary analysis study was to examine the relationships of fatigue and early recovery outcomes (psychosocial and physiologic functioning, and physical activity) over time (6 weeks and 3 months) among older adult subjects, age 65 years and older, after CABG surgery. Comparison groups were those subjects who had fatigue at 3 weeks after surgery and nonfatigued subjects. DESIGN: A prospective, comparative design was used for this secondary analysis study. SAMPLE: Subjects in this study were drawn from the control group of subjects enrolled in the larger parent study. Subjects (N = 119) were dichotomized into fatigue (n = 66) and nonfatigued (n = 53) groups on the basis of their 3-week self-reports of postoperative fatigue. RESULTS: At 6 weeks after surgery, fatigued subjects had significantly (P <.05) more impaired psychosocial functioning (role-emotional [t = 1.91, social [t = 2.6], and mental [t = 1.91 functioning) on the basis of the Medical Outcome Study Short Form 36. They had significantly (P <.005) higher mean hospital anxiety (t = -3.6) and depression (t = -2.9) subscale scores, respectively. Anxiety (t = -2.3, P <.05) remained significantly (P <.05) impaired at 3 months. At 6 weeks, role physical functioning, measured by the Medical Outcome Study Short Form 36, was significantly impaired (t = 2.4, P <.01). There were no significant differences in physical activity variables as measured by an RT3 accelerometer (Stayhealthy, Inc., Monrovia, CA) and self-report diary. CONCLUSIONS: Persistent fatigue can hamper early recovery after CABG surgery. Tailored interventions are needed to address fatigue management and improve patient outcomes.