与健康相关的生活质量是慢性心力衰竭患者生存的独立预测因素吗？
Is health-related quality of life an independent predictor of survival in patients with chronic heart failure?
作者信息
Faller Hermann, Störk Stefan, Schowalter Marion, Steinbüchel Thomas, Wollner Verena, Ertl Georg, Angermann Christiane E
机构信息
Institute of Psychotherapy and Medical Psychology, University of Würzburg, Würzburg, Germany.
出版信息
J Psychosom Res. 2007 Nov;63(5):533-8. doi: 10.1016/j.jpsychores.2007.06.026.
OBJECTIVE
The aim of this study was to examine whether the physical and mental components of health-related quality of life (HRQoL) are independent predictors of survival in patients with chronic heart failure (CHF).
METHODS
A cohort of 231 outpatients with CHF was followed prospectively for 986 days (median; interquartile range=664-1120). Generic HRQoL was measured with the Short Form-36 Health Survey (SF-36), disease-specific HRQoL was measured with the Kansas City Cardiomyopathy Questionnaire, and depression was measured with the self-reported Patient Health Questionnaire.
RESULTS
Both generic and disease-specific HRQoL were predictive of survival on univariate analyses. After adjustment for prognostic factors such as age, gender, degree of left ventricular dysfunction, and functional status, only the mental health component of SF-36 and the disease-specific HRQoL remained significant. When depression was included, both measures also lost their predictive power.
CONCLUSION
Our data suggest that the prognostic value of patients' HRQoL reflects confounding with the severity of disease and comorbid depression.
目的
本研究旨在探讨健康相关生活质量（HRQoL）的身体和心理成分是否为慢性心力衰竭（CHF）患者生存的独立预测因素。
方法
对231例CHF门诊患者进行前瞻性随访986天（中位数；四分位间距=664 - 1120）。采用简短健康调查问卷（SF - 36）测量一般健康相关生活质量，采用堪萨斯城心肌病问卷测量疾病特异性健康相关生活质量，采用自我报告的患者健康问卷测量抑郁情况。
结果
在单因素分析中，一般和疾病特异性健康相关生活质量均为生存的预测因素。在调整年龄、性别、左心室功能障碍程度和功能状态等预后因素后，只有SF - 36的心理健康成分和疾病特异性健康相关生活质量仍具有显著性。纳入抑郁因素后，这两项指标也失去了预测能力。
结论
我们的数据表明，患者健康相关生活质量的预后价值反映了与疾病严重程度和合并抑郁的混杂情况。
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