Arthur H M, Smith K M, Natarajan M K
Faculty of Health Sciences, McMaster University, F.H.Sc. 2J29, 1200 Main Street West, Hamilton, Canada, ON L8N 3Z5.
Int J Cardiol. 2008 May 7;126(1):32-6. doi: 10.1016/j.ijcard.2007.03.111. Epub 2007 May 8.
Patients' anxiety and quality of life (HRQL) are affected by waiting for diagnostic tests such as coronary artery angiogram (CATH). It is unknown whether HRQL and psychological status at the time of referral are related to likelihood of coronary artery disease (CAD) as diagnosed by CATH.
The purposes of this study were (1) to determine patients' anxiety and HRQL at the time of referral for elective CATH and (2) to assess the impact of baseline HRQL on likelihood of CAD.
This was a prospective observational study of 1009 patients referred for elective CATH. Questionnaires were mailed to patients within 2 weeks of referral. Packages contained a general HRQL measure (SF-36), a condition-specific HRQL measure (Seattle Angina Questionnaire) and the State-Trait Anxiety Inventory (STAI). Patients returned the baseline questionnaires in a postage-paid envelope.
: Complete data were available for 90.6% of patients (n=914). At baseline, general HRQL was significantly lower than population norms for healthy individuals (p<0.0001), but significantly higher than population norms for patients living with angina (p<0.02). Also at baseline, patients' (n=971) mean state anxiety score on the STAI was 44.3 (SD=13.3), reflecting 'high anxiety'. Logistic regression analysis revealed 3 predictors of angiographically documented CAD: male sex (OR 5.76; CI 3.75-8.84), the SF-36 physical functioning subscale (OR 1.05; CI 1.01-1.07) and older age (OR 2.38; CI 1.48-3.82).
At the time of referral for elective CATH patients have high levels of anxiety and poor HRQL. It is possible that patient-rated physical HRQL at the time of referral adds to our ability to triage patients according to urgency ratings.
患者的焦虑情绪和生活质量（HRQL）会受到等待冠状动脉造影（CATH）等诊断检查的影响。目前尚不清楚转诊时的HRQL和心理状态是否与CATH诊断的冠状动脉疾病（CAD）可能性相关。
本研究的目的是（1）确定择期CATH转诊时患者的焦虑情绪和HRQL，以及（2）评估基线HRQL对CAD可能性的影响。
这是一项对1009例择期CATH转诊患者的前瞻性观察研究。问卷在转诊后2周内邮寄给患者。问卷包包含一项一般HRQL测量（SF-36）、一项特定疾病HRQL测量（西雅图心绞痛问卷）和状态-特质焦虑量表（STAI）。患者通过邮资已付的信封返还基线问卷。
90.6%的患者（n = 914）有完整数据。在基线时，一般HRQL显著低于健康个体的人群规范（p < 0.0001），但显著高于心绞痛患者的人群规范（p < 0.02）。同样在基线时，患者（n = 971）在STAI上的平均状态焦虑评分为44.3（标准差 = 13.3），反映出“高度焦虑”。逻辑回归分析揭示了血管造影记录的CAD的3个预测因素：男性（比值比5.76；置信区间3.75 - 8.84）、SF-36身体功能子量表（比值比1.05；置信区间1.01 - 1.07）和年龄较大（比值比2.38；置信区间1.48 - 3.82）。
在择期CATH转诊时，患者焦虑水平高且HRQL差。转诊时患者自评的身体HRQL可能会增强我们根据紧急程度对患者进行分诊的能力。
