Rumsfeld J S, Magid D J, O'Brien M, McCarthy M, MaWhinney S, Shroyer A L, Moritz T E, Henderson W G, Sethi G K, Grover F L, Hammermeister K E
Denver Veterans Affairs Medical Center, Colorado 80220, USA.
Ann Thorac Surg. 2001 Dec;72(6):2026-32. doi: 10.1016/s0003-4975(01)03213-1.
There are limited data to help clinicians identify patients likely to have an improvement in quality of life following CABG surgery. We evaluated the relationship between preoperative health status and changes in quality of life following CABG surgery.
We evaluated 1,744 patients enrolled in the VA Cooperative Processes, Structures, and Outcomes in Cardiac Surgery study who completed preoperative and 6-month postoperative Short Form-36 (SF-36) surveys. The primary outcome was change in the Mental Component Summary (MCS) and Physical Component Summary (PCS) scores from the SF-36.
On average, physical and mental health status improved following the operation. Preoperative health status was the major determinant of change in quality of life following surgery, independent of anginal burden and other clinical characteristics. Patients with MCS scores less than 44 or PCS scores less than 38 were most likely to have an improvement in quality of life. Patients with higher preoperative scores were unlikely to have an improvement in quality of life.
Patients with preoperative health status deficits are likely to have an improvement in their quality of life following CABG surgery. Alternatively, patients with relatively good preoperative health status are unlikely to have a quality of life benefit from surgery and the operation should primarily be performed to improve survival.
目前可供临床医生用于识别冠状动脉旁路移植术(CABG)后生活质量可能改善的患者的数据有限。我们评估了术前健康状况与CABG术后生活质量变化之间的关系。
我们评估了参与退伍军人事务部心脏手术合作流程、结构和结果研究的1744例患者,这些患者完成了术前和术后6个月的简短健康调查问卷(SF-36)。主要结局是SF-36中精神健康综合评分(MCS)和生理健康综合评分(PCS)的变化。
平均而言,术后生理和心理健康状况有所改善。术前健康状况是术后生活质量变化的主要决定因素,不受心绞痛负担和其他临床特征的影响。MCS评分低于44或PCS评分低于38的患者生活质量最有可能得到改善。术前评分较高的患者生活质量不太可能得到改善。
术前健康状况存在缺陷的患者在CABG术后生活质量可能会得到改善。相反,术前健康状况相对良好的患者不太可能从手术中获得生活质量益处,手术主要应是为了提高生存率而进行。