Primary Care Clinical Sciences, University of Birmingham, Birmingham B15 2TT, UK.
Europace. 2012 Oct;14(10):1420-7. doi: 10.1093/europace/eus102. Epub 2012 May 10.
To compare the quality of life (QoL) of those in atrial fibrillation (AF) aged 75 years and over with that of the general population, to explore what factors affect the QoL of those with AF, and to assess the sensitivity of the EuroQol (EQ-5D) and Short-Form 12 (SF-12) generic health questionnaires in detecting differences in health status in those with AF in this age group.
The study population was 1762 men and women aged 75 years and over with confirmed AF who attended a randomization clinic for the Birmingham Atrial Fibrillation Treatment of the Aged (BAFTA) study, a primary care based trial of stroke prevention. Patients self-completed the EQ-5D and SF-12 questionnaires, and a simple measure of disability (Rankin). Cardiovascular co-morbidities were collected and number of drugs used as an additional proxy for co-morbidity. Quality-of-life outcomes were compared with general population samples of the same age. On multiple regression, female gender, greater medication use, and disability were independently associated with lower QoL scores in AF. Those in AF with a Rankin score ≥2 had lower QoL scores, while those with a Rankin score <2 had higher scores than the general population. Increasing co-morbidity was associated with reduced QoL scores, with the EQ-5D and SF-12 Physical Component Score showing similar sensitivity to these associations, and the SF-12 Mental Component Score showing less sensitivity.
In the absence of co-morbidity, chronic AF has little impact on generic QoL in an elderly non-acutely ill population.
比较 75 岁及以上心房颤动(AF)患者的生活质量(QoL)与一般人群的生活质量,探讨哪些因素影响 AF 患者的 QoL,并评估 EuroQol(EQ-5D)和 12 项简短健康调查量表(SF-12)在检测该年龄段 AF 患者健康状况差异的敏感性。
研究人群为 1762 名年龄在 75 岁及以上且确诊为 AF 的男性和女性,他们参加了伯明翰心房颤动治疗老年人(BAFTA)研究的随机诊所,这是一项基于初级保健的预防中风试验。患者自行填写 EQ-5D 和 SF-12 问卷,以及简单的残疾量表(Rankin)。收集心血管合并症和使用药物的数量作为合并症的额外替代指标。生活质量结果与同年龄的一般人群样本进行比较。在多变量回归中,女性、更多的药物使用和残疾与 AF 患者的 QoL 评分较低独立相关。Rankin 评分≥2 的 AF 患者的 QoL 评分较低,而 Rankin 评分<2 的患者的 QoL 评分高于一般人群。共病增多与 QoL 评分降低相关,EQ-5D 和 SF-12 生理成分评分对这些关联具有相似的敏感性,而 SF-12 心理成分评分的敏感性较低。
在无合并症的情况下,慢性 AF 对非急性疾病的老年人群的一般 QoL 影响不大。