Quality of life in the first 100 days after suspected acute myocardial infarction--a suitable trial endpoint?

STUDY OBJECTIVE

The aim was to determine the loss of quality of life following admission to hospital with suspected myocardial infarction.

DESIGN

The study involved a cohort of admissions, with interview and follow up for 100 days. Main outcome measures were the quality of life prior to admission and at each stage of convalescence, estimated using the Rosser-Kind matrix: the calculated number of quality adjusted days during a 100 d follow up period.

SETTING

The study took place in a teaching hospital in Scotland.

PATIENTS

206 patients were admitted with suspected acute myocardial infarction. Infarction was confirmed in 160 (Q wave infarcts 100, non-Q-wave infarcts 60), and unconfirmed in 46.

MAIN RESULTS

The quality of life scores before the suspected heart attack were similar for patients whose final diagnosis was Q wave infarction, non-Q-wave infarction, or non-infarction. Of the 160 patients with confirmed infarction, only 54 (34%) had regained their previous quality of life scores at the end of 100 days, compared with 26 of 46 (57%) patients with unconfirmed infarction (p < 0.01). The mean numbers of quality adjusted days lost to patients with Q wave infarction, non-Q-wave infarction, and non-infarction were 17.0, 12.4, and 5.9 respectively (infarction v non-infarction, p < 0.0001). Measurements of both quantity and quality of life contributed to these results.

CONCLUSIONS

The number of quality adjusted days lost after acute myocardial infarction is a practicable measurement that is relevant to patients' lives. It might be suitable as an outcome measure for clinical trials of thrombolytic therapy.