Learning Objective #1: examine the influence of fatigue on early recovery outcomes following CABG surgery.

Learning Objective #2: evaluate the types of early recovery outcomes (psychosocial and physical functioning, and physical activity) which could be improved with a tailored, fatigue management intervention.

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Coronary artery bypass graft (CABG) patients usually obtain relief of cardiac related symptoms and experience improved functioning abilities. However, despite successful cardiac revascularization, some patients suffer from persistent fatigue following their surgery, which can affect their outcomes. The purpose of this study was to examine the influence of persistent fatigue on functioning (psychosocial and physical) and physical activity of older (> 65 years) CABG surgical patients in the early recovery period (6-weeks and 3-months) after hospital discharge. The sample was a subset of 119 CABG subjects, who had been randomized to the control group of a larger, parent study. Subjects were dichotomized into fatigue (n=66) and non-fatigued (n=53) groups based on their 3-week self-report of postoperative fatigue. Fatigued subjects had significantly more psychosocial functioning impairment (role-emotional (t=1.99), social (t=2.60), and mental (t=1.97) functioning), based on the Medical Outcomes Study Short Form-36 (MOS SF-36) subscale mean scores. They also had significantly (p<.005) higher anxiety (t=-3.60) and depression (t= -2.93) mean subscale scores, as measured by the Hospital Anxiety and Depression Scale (HADS) at 6-weeks after surgery. Role physical (6-weeks t=2.45, 3-months t=3.26) and vitality (6-weeks t=3.26, 3-months t=2.27) functioning was significantly (p<.01) impaired for fatigued subjects at 6-weeks following CABG surgery as measured by the MOS SF-36 subscales. Anxiety (t=2.29) and vitality functioning (t=2.35) continued to be significantly (p<.05) impaired for fatigued subjects at 3-months after surgery. At 3-months, the fatigued subjects were expending significantly   (t= -2.00, p<.05) more kilocalories expended per kilogram per day (kcal/kg/day), as measured by diary self-report, compared to non-fatigued subjects. Persistent fatigue can hamper progress following CABG surgery. Interventions tailored to address the management of fatigue, which persists following CABG surgery, are needed to improve patient outcomes.