Westin L, Nilstun T, Carlsson R, Erhardt L
Department of Medical Ethics, University of Lund, Sweden.
Scand Cardiovasc J. 2005 Apr;39(1-2):50-4. doi: 10.1080/14017430410003903.
We have investigated whether perceived quality of life has an impact on long-term survival after a cardiac event.
Male (n = 316) and female (n = 97) patients were assessed by means of a self-administered quality of life questionnaire 1 year after either acute myocardial infarction (n = 296), coronary artery bypass grafting surgery (n = 99) or percutaneous coronary intervention (n = 18). Inclusion period was 1989-1991. Ten years after the last patient answered the 1-year questionnaire, mortality (status factor) up to census date was analysed using nine dimensions of quality of life as covariates (Cox regression).
At 1-year assessment, subjective general health (RR = 3.15), perceived arrhythmia (RR = 1.72), experience of sex life (RR = 1.55), perceived breathlessness (RR = 1.50) and experience of self-esteem (RR = 1.48) were all significantly related to death within the period up to census date.
The findings highlight that the patients' own experience of his or her quality of life, has a prognostic importance for long-term mortality after a cardiac event. Clinicians should be aware that a careful monitoring of perceived quality of life is an important part of good patient care.
我们研究了感知生活质量是否对心脏事件后的长期生存有影响。
对男性（n = 316）和女性（n = 97）患者在急性心肌梗死（n = 296）、冠状动脉搭桥手术（n = 99）或经皮冠状动脉介入治疗（n = 18）1年后，通过自行填写的生活质量问卷进行评估。纳入期为1989年至1991年。在最后一名患者回答1年问卷10年后，以生活质量的九个维度作为协变量（Cox回归）分析截至普查日期的死亡率（状态因素）。
在1年评估时，主观总体健康状况（RR = 3.15）、感知心律失常（RR = 1.72）、性生活体验（RR = 1.55）、感知呼吸急促（RR = 1.50）和自尊体验（RR = 1.48）均与截至普查日期的死亡显著相关。
研究结果突出表明，患者自身对其生活质量的体验对心脏事件后的长期死亡率具有预后重要性。临床医生应意识到，仔细监测感知生活质量是优质患者护理的重要组成部分。
