Falcoz Pierre Emmanuel, Chocron Sidney, Laluc Frederic, Puyraveau Marc, Kaili Djamel, Mercier Mariette, Etievent Joseph Philippe
Department of Thoracic and Cardiovascular Surgery, Jean-Minjoz Hospital, Besançon, France.
Ann Thorac Surg. 2006 May;81(5):1637-43. doi: 10.1016/j.athoracsur.2005.12.004.
The aim of this prospective study, based on the iterative completion of the 36-item short form health survey questionnaire (SF36) after open heart surgery, was twofold: to evaluate the changes in quality of life (QOL) scores (over time and by gender, and also in comparison with scores from a normal population) and to identify possible gender differences in two-year cardiac functional status.
From July 2000 to July 2002, 590 elective patients were included in this study. Baseline and follow-up QOL surveys were obtained for 439 patients (307 males and 132 females). The QOL scores were compared by gender, by analysis of variance, and by the Student t test. Factors influencing two-year cardiac functional status were determined by logistic regression.
The comparison of baseline and follow-up scores showed a significant improvement (a sharp increase between baseline and year one, then stabilization) in all dimensions of the SF36, two years after surgery in all patients. However, QOL was significantly lower in women than in men in all but two dimensions; at baseline and during follow-up. When compared with the normal population, men and women over 75 had a similar QOL. The best independent predictive factor of two-year cardiac functional status in women was the physical component summary score and in men, the mental component summary score.
The benefit of open heart surgery at two-year follow-up is equivalent in both genders in terms of QOL, although women had lower baseline QOL scores.
这项前瞻性研究的目的是双重的,基于心脏直视手术后对36项简短健康调查问卷(SF36)的迭代完成:评估生活质量(QOL)评分的变化(随时间和性别变化,以及与正常人群评分进行比较),并确定两年心脏功能状态中可能存在的性别差异。
从2000年7月至2002年7月,590例择期手术患者纳入本研究。对439例患者(307例男性和132例女性)进行了基线和随访QOL调查。通过方差分析和学生t检验按性别比较QOL评分。通过逻辑回归确定影响两年心脏功能状态的因素。
基线和随访评分的比较显示,所有患者术后两年,SF36的所有维度均有显著改善(基线至第一年急剧增加,然后稳定)。然而,除两个维度外,女性在所有维度的QOL均显著低于男性;在基线和随访期间均如此。与正常人群相比,75岁以上的男性和女性QOL相似。女性两年心脏功能状态的最佳独立预测因素是身体成分汇总评分,男性是精神成分汇总评分。
尽管女性基线QOL评分较低,但在两年随访时,心脏直视手术对男女QOL的益处相当。