Grady Kathleen L, Wang Edward, Higgins Robert, Heroux Alain, Rybarczyk Bruce, Young James B, Pelegrin Dave, Czerr Jennifer, Kobashigawa Jon, Chait Julie, Naftel David C, White Williams Connie, Myers Susan, Kirklin James K
Northwestern Memorial Hospital, Chicago, IL, USA.
J Heart Lung Transplant. 2009 Aug;28(8):759-68. doi: 10.1016/j.healun.2009.04.020. Epub 2009 Jun 28.
Patterns of symptom frequency and distress have not been examined long-term after heart transplantation, nor have predictors of long-term symptom frequency and distress. This report identified the most commonly reported and distressful symptoms long-term after transplantation, described patterns of symptom frequency and distress over time, and examined predictors of symptom frequency and distress at 5 and 10 years after heart transplantation.
The sample included 555 participants from a prospective, multisite, longitudinal study of quality of life outcomes. Patients were 78% male, 88% white, 79% married, and mean age of 54 years at time of heart transplantation. Data were collected using patient self-report and medical records review. Statistical analyses included descriptive statistics, Pearson correlations, t-tests, and generalized linear models.
Significant predictors of lower symptom frequency after heart transplantation were not having psychological problems and not having cardiac allograft vasculopathy at 5 years, and not having psychological problems and not having infection at 10 years. Significant predictors of less symptom distress were having more than a high school education, having no psychological problems, and having gout at 5 years, and being married at 10 years.
Symptom frequency is low and symptom distress is moderate long-term after heart transplantation. Significant relationships exist between both demographic and clinical variables and symptom frequency and distress. Identification of the most common and bothersome symptoms after heart transplantation provides clinicians with important information from which to develop a plan of care.
心脏移植术后症状频率和困扰模式尚未得到长期研究,长期症状频率和困扰的预测因素也未得到研究。本报告确定了移植后长期最常报告的令人困扰的症状,描述了症状频率和困扰随时间的变化模式,并研究了心脏移植后5年和10年症状频率和困扰的预测因素。
样本包括555名来自一项前瞻性、多中心、纵向生活质量结局研究的参与者。患者中男性占78%,白人占88%,已婚者占79%,心脏移植时的平均年龄为54岁。数据通过患者自我报告和病历审查收集。统计分析包括描述性统计、Pearson相关性分析、t检验和广义线性模型。
心脏移植后症状频率较低的显著预测因素在5年时为没有心理问题和没有心脏移植血管病变,在10年时为没有心理问题和没有感染。症状困扰较少的显著预测因素在5年时为接受过高中以上教育、没有心理问题和患有痛风,在10年时为已婚。
心脏移植术后长期症状频率较低,症状困扰为中度。人口统计学和临床变量与症状频率和困扰之间均存在显著关系。确定心脏移植后最常见和最困扰的症状为临床医生制定护理计划提供了重要信息。