1st Department of Cardiac Surgery, Medical University of Silesia, Katowice-Ochojec, Poland.
Kardiol Pol. 2012;70(9):890-6.
Quality of life (QoL) is an acknowledged parameter that subjectively describes treatment effectiveness and is used also in cardiac surgery. Minimally-invasive totally endoscopic atraumatic coronary artery bypass grafting (EACAB) does not require the use of cardiopulmonary bypass, reduces hospital stay and facilitates early rehabilitation. Therefore, this procedure should significantly improve QoL in patients with coronary artery disease.
To assess QoL during a 12-year follow-up in patients who underwent EACAB.
The study group comprised 706 consecutive patients who underwent EACAB between April 1998 and December 2010. Median duration of follow-up was 1918 days. QoL was assessed by either telephone interview or letter correspondence. Complete data were obtained from 413 persons aged 59 ± 6 years. We evaluated the effect of pre- and postoperative variables on QoL.
Compared with the preoperative period, a marked improvement in QoL after EACAB was reported by 38.6%, and improvement by 37.2% of patients. No change in QoL was noted by 18.8% of subjects, and 5.4% of responders reported deterioration of QoL. The following parameters were found to have no impact on QoL: gender (p = 0.3), myocardial infarction (MI) before EACAB (p = 0.3), diabetes mellitus (p = 0.7), and baseline angina severity by the Canadian Cardiovascular Society (CCS) classification (p = 0.8). Time delay between the surgery and QoL assessment had no impact on the results. During the follow-up, reported QoL was related to the severity of angina symptoms (p = 0.006), need for rehospitalisation (p = 0.02), MI (p = 0.04) and repeated revascularisation (p = 0.02). In multivariate analysis, only MI had a significant impact on QoL (p = 0.04). Current drug therapy had no impact on QoL.
EACAB significantly improved QoL in coronary patients. MI during follow-up was associated with deterioration of QoL.
生活质量（QoL）是一个公认的参数，它主观地描述了治疗效果，也用于心脏手术。微创全内窥镜非创伤性冠状动脉旁路移植术（EACAB）不需要使用体外循环，可减少住院时间并促进早期康复。因此，这种手术应该会显著改善冠心病患者的生活质量。
评估 EACAB 后 12 年的患者生活质量。
研究组包括 1998 年 4 月至 2010 年 12 月期间接受 EACAB 的 706 例连续患者。中位随访时间为 1918 天。通过电话访谈或信件往来评估生活质量。从 413 名年龄 59 ± 6 岁的患者中获得完整数据。我们评估了术前和术后变量对生活质量的影响。
与术前相比，38.6%的患者报告 EACAB 后生活质量明显改善，37.2%的患者报告生活质量改善。18.8%的患者生活质量没有变化，5.4%的患者报告生活质量恶化。以下参数对生活质量没有影响：性别（p = 0.3）、EACAB 前心肌梗死（MI）（p = 0.3）、糖尿病（p = 0.7）和加拿大心血管学会（CCS）分类的基线心绞痛严重程度（p = 0.8）。手术与生活质量评估之间的时间延迟对结果没有影响。在随访期间，报告的生活质量与心绞痛症状的严重程度（p = 0.006）、再住院需求（p = 0.02）、MI（p = 0.04）和重复血运重建（p = 0.02）相关。多变量分析显示，只有 MI 对生活质量有显著影响（p = 0.04）。当前的药物治疗对生活质量没有影响。
EACAB 显著改善了冠心病患者的生活质量。随访期间发生的 MI 与生活质量恶化相关。
