Al-Ruzzeh S, Athanasiou T, Mangoush O, Wray J, Modine T, George S, Amrani M
Leeds General Infirmary, UK.
Heart. 2005 Dec;91(12):1557-62. doi: 10.1136/hrt.2004.047068.
To assess the determinants of poor mid-term health related quality of life (HRQoL) at one year after primary isolated coronary artery bypass grafting (CABG).
463 patients who underwent primary isolated CABG for multivessel disease and came for their annual follow up at the outpatient clinic during one year at Harefield Hospital, Middlesex, were approached to participate in the present study. Prospective clinical data were collected as part of the clinical care of the patients and were retrospectively analysed when the patients consented to participate in the study at their outpatient visit. After their consent they were given three HRQoL assessment questionnaires. Scores, together with clinical data, were analysed by both univariate and multivariate analyses with regard to poor HRQoL outcome.
437 (94.4%) patients consented to participate in the study and filled in the HRQoL questionnaires. Ten variables were identified in the univariate analysis as potential predictors of poor scores of the physical element of HRQoL; however, only three variables-gastrointestinal problems, congestive heart failure, and type D personality trait-predicted poor physical scores independently. Eleven variables were identified in the univariate analysis as potential predictors of poor scores of the mental element of HRQoL; however, only three variables-peripheral vascular disease, infective complications, and type D personality trait-predicted poor physical scores independently.
Preoperative gastrointestinal problems, preoperative congestive heart failure, and type D personality trait were independent predictors of the poor physical component of HRQoL. Peripheral vascular disease, infective complications, and type D personality trait were independent predictors of the poor mental component of HRQoL. Interestingly, patients with type D personality were more than twice as likely to have poor physical HRQoL and more than five times as likely to have poor mental HRQoL.
评估初次单纯冠状动脉旁路移植术(CABG)一年后中期健康相关生活质量(HRQoL)较差的决定因素。
463例因多支血管病变接受初次单纯CABG的患者在米德尔塞克斯郡哈雷菲尔德医院门诊进行年度随访时被邀请参与本研究。前瞻性临床数据作为患者临床护理的一部分进行收集,当患者在门诊就诊时同意参与研究时进行回顾性分析。在他们同意后,给他们发放了三份HRQoL评估问卷。就HRQoL结果较差的情况,对得分以及临床数据进行单因素和多因素分析。
437例(94.4%)患者同意参与研究并填写了HRQoL问卷。单因素分析确定了10个变量作为HRQoL身体要素得分较差的潜在预测因素;然而,只有三个变量——胃肠道问题、充血性心力衰竭和D型人格特质——独立预测了较差的身体得分。单因素分析确定了11个变量作为HRQoL心理要素得分较差的潜在预测因素;然而,只有三个变量——外周血管疾病、感染性并发症和D型人格特质——独立预测了较差的身体得分。
术前胃肠道问题、术前充血性心力衰竭和D型人格特质是HRQoL身体组成部分较差的独立预测因素。外周血管疾病、感染性并发症和D型人格特质是HRQoL心理组成部分较差的独立预测因素。有趣的是,D型人格的患者身体HRQoL较差可能性是其他人的两倍多,心理HRQoL较差可能性是其他人的五倍多。