Groeneveld Peter W, Matta Mary A, Suh Janice J, Yang Feifei, Shea Judy A
Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA.
Pacing Clin Electrophysiol. 2007 Apr;30(4):463-71. doi: 10.1111/j.1540-8159.2007.00694.x.
Although patients receiving implantable cardioverter-defibrillators (ICDs) for primary prevention of sudden cardiac death are the fastest growing segment of the ICD recipient population, the quality-of-life (QOL) effects of the ICD among primary prevention patients are not well understood. The purpose of this study was to measure and compare the health-related QOL among primary and secondary prevention ICD recipients, and to determine predictive factors for high or low QOL in each group.
Forty-five primary prevention and 75 secondary prevention ICD recipients receiving routine care in electrophysiology clinics within the University of Pennsylvania Health System were assessed using several well-validated general and ICD-specific QOL instruments.
Between primary and secondary prevention patients, there were no significant differences in EuroQol 5D (medians: 0.84 vs 0.84, P = 0.71), Health Utilities Index (medians: 0.88 vs 0.85, P = 0.95), Short Form-12 aggregate physical summary (means: 45 vs 46, P = 0.64), and Short Form-12 aggregate mental summary (means: 46 vs 47, P = 0.93) scores. Both primary and secondary prevention patients viewed their devices favorably according to the Florida Patient Acceptance Survey scale, with no significant differences between group means (80 vs 83, P = 0.71). However, substantial fractions of both primary and secondary prevention recipients had particular concerns about lifting (40%), sexual activity (19%), and driving (14%).
QOL does not significantly differ between primary prevention and secondary prevention ICD recipients. Device recipients had comparable QOL to published, nationwide QOL estimates among non-ICD patients of similar age. The ICD was highly acceptable to most primary and secondary prevention patients.
尽管接受植入式心脏复律除颤器（ICD）进行心脏性猝死一级预防的患者是ICD接受者群体中增长最快的部分，但ICD对一级预防患者生活质量（QOL）的影响尚未得到充分了解。本研究的目的是测量和比较一级和二级预防ICD接受者的健康相关生活质量，并确定每组中生活质量高或低的预测因素。
使用几种经过充分验证的一般和特定于ICD的生活质量工具，对宾夕法尼亚大学医疗系统电生理诊所接受常规护理的45名一级预防和75名二级预防ICD接受者进行评估。
在一级和二级预防患者之间，欧洲五维健康量表（中位数：0.84对0.84，P = 0.71）、健康效用指数（中位数：0.88对0.85，P = 0.95）、简明健康调查问卷12项身体综合评分（均值：45对46，P = 0.64）和简明健康调查问卷12项心理综合评分（均值：46对47，P = 0.93）得分均无显著差异。根据佛罗里达患者接受度调查量表，一级和二级预防患者对其设备的评价都很高，两组均值之间无显著差异（80对83，P = 0.71）。然而，一级和二级预防接受者中相当一部分人对提举（40%）、性活动（19%）和驾驶（14%）特别担心。
一级预防和二级预防ICD接受者的生活质量无显著差异。设备接受者的生活质量与已公布的全国范围内类似年龄非ICD患者的生活质量估计值相当。大多数一级和二级预防患者对ICD高度接受。
