Colak Zeljko, Segotic Iva, Uzun Sandra, Mazar Mirabel, Ivancan Visnja, Majeric-Kogler Visnja
Department of Anesthesiology, Reanimatology and Intensive Care, Clinical Hospital Center Zagreb, Kispaticeva 12, Zagreb, Croatia.
Eur J Cardiothorac Surg. 2008 Jan;33(1):72-6. doi: 10.1016/j.ejcts.2007.09.023. Epub 2007 Oct 31.
To explore differences in the health-related quality of life (HRQOL) of patients before and after cardiac surgery, to compare the results with norms of Croatian population and to correlate the results with values of EuroSCORE.
This was a prospective observational study with repeated measurements using the Short Form SF-36 health survey before surgery and 1 year after discharge, to assess changes in quality of life.
A total number of 111 patients were included in the study. Seventy-one patients (64%) responded to second measurement of HRQOL 1 year after surgery. The mean age was 61 years, patients were predominantly male and the majority of patients were admitted for coronary artery bypass graft. The prevalence of comorbidity was relatively high. Preoperative mean values of study population were statistically lower than those representing Croatian general population in five out of eight health domains: physical functioning (p<0.001), role physical (p<0.001), bodily pain (p<0.001), social functioning (p<0.001) and mental health (p<0.001). Data show significant improvement 1 year after discharge in four out of eight health domains: physical functioning (p=0.02), role physical (p<0.001), social functioning (p=0.004) and mental health (p=0.03). A subgroup of 30 patients with EuroSCORE > or =6 shows postdischarge improvements in the majority of scales: role physical (p<0.001), bodily pain (p<0.001), vitality (p=0.03), social functioning (p=0.01), role emotional (p=0.03) and mental health (p=0.002), and group with EuroSCORE <6 shows postdischarge improvement only in one health domain - role physical (p<0.001).
The health status of patients one year after hospital discharge shows a statistically significant improvement in half of the domains of physical and mental health compared with presurgery status. The high-risk group of patients (EuroSCORE > or =6) were likely to have significant improvement in greater number of health domains following surgery than the low- and medium-risk group (EuroSCORE <6).
探讨心脏手术后患者健康相关生活质量(HRQOL)的差异,将结果与克罗地亚人群的标准进行比较,并将结果与欧洲心脏手术风险评估系统(EuroSCORE)的值进行关联。
这是一项前瞻性观察性研究,在手术前和出院后1年使用简短健康调查问卷SF-36进行重复测量,以评估生活质量的变化。
共有111名患者纳入研究。71名患者(64%)在术后1年对HRQOL的第二次测量做出了回应。平均年龄为61岁,患者以男性为主,大多数患者因冠状动脉搭桥术入院。合并症的患病率相对较高。在八个健康领域中的五个领域,研究人群的术前平均值在统计学上低于代表克罗地亚普通人群的数值:身体功能(p<0.001)、身体角色(p<0.001)、身体疼痛(p<0.001)、社会功能(p<0.001)和心理健康(p<0.001)。数据显示,出院后1年,八个健康领域中的四个领域有显著改善:身体功能(p=0.02)、身体角色(p<0.001)、社会功能(p=0.004)和心理健康(p=0.03)。EuroSCORE≥6的30名患者亚组在大多数量表上出院后有所改善:身体角色(p<0.001)、身体疼痛(p<0.001)、活力(p=0.03)、社会功能(p=0.01)、情感角色(p=0.03)和心理健康(p=0.002),而EuroSCORE<6的组仅在一个健康领域——身体角色(p<0.001)出院后有所改善。
与术前状态相比,出院后1年患者的健康状况在身心健康领域的一半方面有统计学上的显著改善。高风险患者组(EuroSCORE≥6)术后在更多健康领域可能比低风险和中风险组(EuroSCORE<6)有更显著的改善。