Failde Inmaculada I, Soto Maria M
Area de Medicina Preventiva y Salud Pública, Universidad de Cádiz, Spain.
BMC Public Health. 2006 Jan 27;6:18. doi: 10.1186/1471-2458-6-18.
The aim of the study was to identify the changes in Health Related Quality of Life (HRQL) 3 months after discharge from hospital, in patients who have had an acute coronary episode, and to determine the clinical and sociodemographic variables that explain those changes.
HRQL was assessed in 132 patients while they were admitted to the hospital and at 3 months after discharge, using the SF-36 health questionnaire. To identify the variables associated with the change, multiple linear regression models were constructed for two summary dimensions of the SF-36 (PCS and MCS) taking the change in the score of the dimension as dependent variable.
There were no significant differences between the patients who completed the monitoring (n = 76) and those who were dropped out. After three months, a significant decrease was observed in the dimensions of physical functioning, general health, vitality, and Physical Summary Component (PCS). The variables revascularisation, age, and the interaction between previous history of coronary heart disease (CHD) and the presence of one or more risk factors explained 16.6% of the decrease in the PCS. The decrease in the PCS was 6.4 points less in the patients who had undergone revascularisation, 0.2 points less for each year of age, and 4.7 points less in the patients who had antecedents of the illness as well as one or more risk factors.
The dimensions most affected at three months after an acute coronary episode were those related to the physical component. Undergoing revascularisation improved the PCS in patients, but in the younger patients and those without personal antecedents or risk factors, the PCS was affected more, perhaps due to greater expectations for recovery in these patients.
本研究的目的是确定急性冠脉事件患者出院3个月后健康相关生活质量(HRQL)的变化,并确定解释这些变化的临床和社会人口统计学变量。
使用SF-36健康问卷对132例患者在入院时和出院后3个月进行HRQL评估。为了确定与变化相关的变量,以SF-36的两个总结维度(PCS和MCS)的得分变化为因变量,构建多元线性回归模型。
完成监测的患者(n = 76)与退出研究的患者之间无显著差异。三个月后,身体功能、总体健康、活力和身体总结成分(PCS)维度均出现显著下降。血管重建、年龄以及冠心病(CHD)既往史与一个或多个危险因素之间的相互作用这几个变量解释了PCS下降的16.6%。接受血管重建的患者PCS下降幅度少6.4分,年龄每增加一岁下降幅度少0.2分,有疾病史以及一个或多个危险因素的患者PCS下降幅度少4.7分。
急性冠脉事件发生三个月后受影响最大的维度是与身体成分相关的维度。接受血管重建改善了患者的PCS,但在年轻患者以及没有个人病史或危险因素的患者中,PCS受影响更大,这可能是由于这些患者对康复的期望更高。