Spaziano Marco, Carrier Michel, Pellerin Michel, Choinière Manon
Department of Internal Medicine, Faculty of Medicine, University of Montreal, Hôpital du Sacré-Coeur de Montréal, Quebec, Canada.
J Heart Valve Dis. 2010 Jul;19(4):524-32.
The purpose of this investigation was to evaluate both long-term functional status and quality of life (QoL) following valvular replacement surgery in octogenarians. The influence of gender and discharge location was also examined.
A total of 133 patients (age range: 80-89 years) who underwent surgical valve replacement between January 2003 and December 2006 was identified. Two questionnaires evaluating QoL (SF-12v2 and MLHFQ), as well as a demographic questionnaire, were sent to these patients.
The response rate was 64.4%. Among the participants, the mean NYHA functional class improved from 2.7 to 1.4 after surgery. Men showed results similar to those of the age-matched general Canadian population on the mental and physical component scales of the SF-12v2. The data on women were similar to those of the general population on the physical component scale, but their scores were significantly lower on the mental component scale of the SF-12v2. Further analysis of the results comparing discharge location for each gender revealed that women discharged to a convalescence resource had significantly better QoL scores than those discharged to home with regards to the physical component scale of the SF-12v2, the total score of the MLHFQ, and the physical dimension score of the MLHFQ.
Patients aged > or = 80 years benefit from heart valve replacement surgery in terms of both QoL and functional status. Women may be at increased risk of a decline in their emotional well-being and, postoperatively, may benefit more from convalescence than from discharge to home.
本调查旨在评估八旬老人瓣膜置换手术后的长期功能状态和生活质量（QoL）。同时也研究了性别和出院地点的影响。
确定了2003年1月至2006年12月期间接受手术瓣膜置换的133例患者（年龄范围：80 - 89岁）。向这些患者发送了两份评估生活质量的问卷（SF - 12v2和MLHFQ）以及一份人口统计学问卷。
回复率为64.4%。参与者中，术后纽约心脏协会（NYHA）心功能分级平均从2.7改善至1.4。在SF - 12v2的心理和身体成分量表上，男性的结果与年龄匹配的加拿大普通人群相似。女性在SF - 12v2身体成分量表上的数据与普通人群相似，但在SF - 12v2心理成分量表上的得分显著较低。对按性别比较出院地点的结果进行进一步分析发现，如果以SF - 12v2身体成分量表、MLHFQ总分以及MLHFQ身体维度得分来衡量，出院到康复机构的女性生活质量得分明显高于出院回家的女性。
年龄≥80岁的患者在生活质量和功能状态方面均从心脏瓣膜置换手术中获益。女性情感幸福感下降的风险可能更高，术后从康复中获益可能比出院回家更多。
