Quintana J M, Arostegui I, Oribe V, López de Tejada I, Barrios B, Garay I
Unidad de Investigación, Hospital de Galdakao, Galdakao, Spain.
Qual Life Res. 2005 Apr;14(3):815-25. doi: 10.1007/s11136-004-1259-z.
Few studies have assessed the role of sociodemographic characteristics on outcomes after a cholecystectomy. Our goal was to evaluate the influence of age and gender on the health related quality of life (HRQoL) changes after cholecystectomy in this prospective observational study of consecutive patients undergoing cholecystectomy. Patients completed the SF-36 and the Gastrointestinal Quality of Life Index (GIQLI) before intervention and 3 months later. The influence of age, gender, and the pre-intervention health status on the HRQoL changes was studied by multivariate regression analysis. Older patients had poorer HRQoL and their post-intervention improvement was lower than younger patients. Compared with men, women had worse health status before the intervention measured with both HRQoL tools. In the unadjusted analysis women had greater improvements than men, measured by the GIQLI, but not with the SF-36. However, after controlling for other relevant variables, the SF-36 measured lower improvements in women more often than men, but the GIQLI showed similar results for both. For men and women, the lower the pre-intervention health status the higher the post-operative improvement. Women presented with worse health status before the intervention and less improvement post-operatively after adjustments. The pre-intervention health status has an important role explaining changes after the intervention. A gender-related difference exists between what a generic and a disease-specific HRQoL instrument captures when measuring HRQoL improvement after cholecystectomy.
很少有研究评估社会人口学特征在胆囊切除术后结局中的作用。在这项对连续接受胆囊切除术的患者进行的前瞻性观察研究中,我们的目标是评估年龄和性别对胆囊切除术后健康相关生活质量(HRQoL)变化的影响。患者在干预前和3个月后完成了SF-36和胃肠道生活质量指数(GIQLI)。通过多变量回归分析研究年龄、性别和干预前健康状况对HRQoL变化的影响。老年患者的HRQoL较差,且他们干预后的改善程度低于年轻患者。与男性相比,使用两种HRQoL工具测量,女性在干预前的健康状况更差。在未调整分析中,以GIQLI衡量,女性比男性有更大的改善,但以SF-36衡量则不然。然而,在控制其他相关变量后,SF-36测量显示女性比男性更常出现较低的改善,但GIQLI对两者显示出相似的结果。对于男性和女性,干预前健康状况越低,术后改善越高。女性在干预前健康状况较差,调整后术后改善较少。干预前健康状况在解释干预后的变化方面起着重要作用。在测量胆囊切除术后HRQoL改善时,通用和疾病特异性HRQoL工具所反映的情况存在性别差异。