Hunt J O, Hendrata M V, Myles P S
Alfred Hospital, Prahran, Victoria, Australia.
Heart Lung. 2000 Nov-Dec;29(6):401-11. doi: 10.1067/mhl.2000.110578.
The primary purpose of this study was to assess the relationship between preoperative risk factors, postoperative chronic pain, sleep, and gender on perceptions of quality of life (QoL) in a sample of 123 coronary artery bypass graft (CABG) surgery patients 12 months after surgery. A secondary purpose was to determine whether there is concordance between spousal and patient reporting of QoL after CABG surgery.
A cross-sectional comparative study.
The study setting included patients living in the community, who had had CABG surgery 12 months earlier at The Alfred hospital, a major metropolitan public acute care center, in Melbourne, Australia.
Study participants were 123 adult patients (mean age = 64 years) who had undergone CABG surgery and had participated in a recent clinical trial. These patients were followed up to 12 months. The patient's spouse or next of kin (NoK) was asked questions about their perception of change in the patient's QoL.
Results were assessed using The Medical Outcome Study Short Form-36 (SF-36) questionnaire and additional questions given at 12 months after CABG surgery. The Cleveland Clinic Clinical Severity Score (CSS) was used preoperatively as a tool to predict QoL outcome.
Significant improvements in QoL, as measured by the SF-36, were seen in physical functioning (P <.0001), bodily pain (P =.024), social functioning (P =.011), and role limitations resulting from emotional status (P =.003). Other significant associations (P =.002) were found between poor QoL and patients who reported severe pain or poor quality sleep. Low-risk patients, as identified by the preoperative CSS, were more likely to have improved QoL at 12 months. Alteration in QoL was reported equally by patients and their spouses or NoK. Short-term memory impairment was reported by 41% of spouses or NoK.
CABG surgery results in improved QoL for the majority of patients with extensive coronary artery disease. Nevertheless, some patients continue to have severe pain, sleep disturbances, and altered relationship with their spouse or NoK 12 months after surgery.
本研究的主要目的是评估123例冠状动脉旁路移植术（CABG）患者术后12个月时，术前危险因素、术后慢性疼痛、睡眠及性别与生活质量（QoL）认知之间的关系。次要目的是确定CABG术后配偶与患者对QoL的报告是否一致。
横断面比较研究。
研究对象包括居住在社区的患者，他们12个月前在澳大利亚墨尔本一家大型都市公立急症中心阿尔弗雷德医院接受了CABG手术。
研究参与者为123例成年患者（平均年龄=64岁），他们接受了CABG手术并参加了最近的一项临床试验。这些患者被随访至12个月。患者的配偶或近亲被问及他们对患者QoL变化的看法。
使用医学结局研究简明健康调查（SF-36）问卷及CABG术后12个月时给出的附加问题评估结果。术前使用克利夫兰诊所临床严重程度评分（CSS）作为预测QoL结果的工具。
SF-36测量显示，在身体功能（P<.0001）、身体疼痛（P=.024）、社会功能（P=.011）以及因情绪状态导致的角色限制（P=.003）方面，QoL有显著改善。在QoL差与报告有严重疼痛或睡眠质量差的患者之间还发现了其他显著关联（P=.002）。术前CSS确定的低风险患者在12个月时更有可能改善QoL。患者及其配偶或近亲报告的QoL改变程度相同。41%的配偶或近亲报告有短期记忆障碍。
对于大多数患有广泛冠状动脉疾病的患者，CABG手术可改善QoL。然而，一些患者在术后12个月仍有严重疼痛、睡眠障碍以及与配偶或近亲关系的改变。
