Karlsson I, Berglin E, Pettersson G, Larsson P A
College of Health and Caring Sciences, Faculty of Medicine, Göteborg University, Sweden.
Scand Cardiovasc J. 1999;33(5):289-94. doi: 10.1080/14017439950141542.
To identify preoperative biopsychosocial factors characterizing patients who will experience chest pain (self-reported) one year after coronary artery bypass grafting (CABG), 111 patients under 61 years of age were evaluated by questionnaire before CABG and 12 months postoperatively. A "Coronary Health Profile" was evolved to study quality-of-life indicators, e.g. "Sense of Coherence" (SOC), emotional state (loneliness, depressed mood, stress, anxiety) and social support as well as experience of chest pain, and the results were correlated to biomedical data. Chest pain was experienced in the first postoperative year by 34% of the patients. These patients, who were younger than those without chest pain, generally had a body mass index >25, as well as lower preoperative values for SOC, poorer emotional state and social support. Independent predictors in a multivariate stepwise logistic regression analysis were moderate/weak SOC, ejection fraction <50%, and moderate/severe mood depression. We conclude that biomedical as well as psychosocial factors have a significant impact as predictors of chest pain (of any origin) after CABG, and must be considered in preoperative evaluation. The findings indicate the need for biopsychosocial support/intervention before as well as after CABG.
为了确定冠状动脉搭桥术（CABG）后一年出现胸痛（自我报告）患者的术前生物心理社会特征，对111名61岁以下患者在CABG术前及术后12个月进行问卷调查评估。制定了一份“冠状动脉健康概况”来研究生活质量指标，如“连贯感”（SOC）、情绪状态（孤独感、抑郁情绪、压力、焦虑）和社会支持以及胸痛经历，并将结果与生物医学数据相关联。34%的患者在术后第一年经历了胸痛。这些患者比无胸痛的患者年轻，一般体重指数>25，术前SOC值较低，情绪状态和社会支持较差。多变量逐步逻辑回归分析中的独立预测因素为中度/轻度SOC、射血分数<50%以及中度/重度情绪抑郁。我们得出结论，生物医学因素以及心理社会因素作为CABG后胸痛（任何原因引起）的预测因素具有显著影响，在术前评估中必须予以考虑。研究结果表明，在CABG术前及术后都需要生物心理社会支持/干预。
