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老年冠状动脉搭桥术患者体重指数变化与术后晚期结局:一项随访研究

Changes in body mass index and late postoperative outcomes in elderly coronary bypass grafting patients: a follow-up study.

作者信息

DiMaria-Ghalili Rose Ann

机构信息

West Virginia University, School of Nursing, Charleston, WV 25304, USA.

出版信息

Biol Res Nurs. 2004 Jul;6(1):24-36. doi: 10.1177/1099800404264538.

Abstract

The purpose of this study was to describe the extent to which late postoperative health outcomes vary as a function of change in body mass index (BMI) in per-sons > or = 65 years of age undergoing elective coronary artery bypass grafting (CABG). The mean age of the 90 persons in the original sample was 72.27 (+/-4.85) years. At follow-up x = 18.73, s = 2.56 months postsurgery), 90% (n = 79 alive, n = 2 deceased, proxy completed interview) were contacted; 73% (n = 59)completed the telephone interview; and 9% (n = 8) were alive but lost to follow-up. BMI (kg/m(2)) was calculated from self-reported weight at follow-up. Out-comes included the Physical Component Summary(PCS) scale of the SF-36 Health Survey and readmission data. The ()x (s) for BMI at preoperative, postoperative, postdischarge, and follow-up were 28.1 (4.9) kg/m(2), 28.76 (4.9) kg/m(2), 27.11 (4.8) kg/m(2), and 27.95(4.7) kg/m(2), respectively. BMI changed over time, P <0.05. Those who were readmitted lost more weight between preoperative and postdischarge than those who were not readmitted (()f BMI = -2.26 vs. ()x BMI =-1.35), t = 2.17, df = 27.05, P = 0.04. Those who lost less weight between preoperative and postdischarge were less likely to be readmitted, X2 = 5.755 (1), P =0.02, with 25% sensitivity and 92% specificity. The ()x(s(x)(-)) for PCS at preoperative, postdischarge, and follow-up were 36.93 (1.62), 35.72 (1.27), and 42.26 (1.45), respectively, reflecting change over time, F =11.43 (2), P < 0.001. At follow-up, older elective CABG patients do not appear to regain weight lost between preoperative and postdischarge; however,self-reported physical health is improved. Also, initial weight loss is related to readmissions.

摘要

本研究的目的是描述年龄≥65岁接受择期冠状动脉旁路移植术(CABG)的患者术后健康结局随体重指数(BMI)变化而变化的程度。原始样本中90人的平均年龄为72.27(±4.85)岁。在随访时(术后x = 18.73,s = 2.56个月),90%(n = 79人存活,n = 2人死亡,由代理人完成访谈)被联系;73%(n = 59)完成了电话访谈;9%(n = 8)存活但失访。BMI(kg/m²)根据随访时自我报告的体重计算得出。结局包括SF-36健康调查的生理健康总结(PCS)量表和再入院数据。术前、术后、出院后及随访时BMI的()x(s)分别为28.1(4.9)kg/m²、28.76(4.9)kg/m²、27.11(4.8)kg/m²和27.95(4.7)kg/m²,BMI随时间变化,P <0.05。再入院患者术前至出院后体重减轻比未再入院患者更多(()f BMI = -2.26 vs.()x BMI = -1.35),t = 2.17,df = 27.05,P = 0.04。术前至出院后体重减轻较少的患者再入院可能性较小,X² = 5.755(1),P = 0.02,敏感度为25%,特异度为92%。术前、出院后及随访时PCS的()x(s(x)(-))分别为36.93(1.62)、35.72(1.27)和42.26(1.45),反映了随时间的变化,F = 11.43(2),P <0.001。在随访时,年龄较大的择期CABG患者似乎未恢复术前至出院后减轻的体重;然而,自我报告的身体健康状况有所改善。此外,初始体重减轻与再入院有关。

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