自我评估的健康状况与心脏手术后在重症监护病房和医院的住院时间有关。
Self-rated health is associated with the length of stay at the intensive care unit and hospital following cardiac surgery.
作者信息
Cserép Zsuzsanna, Losoncz Eszter, Tóth Roland, Tóth Attila, Juhász Boglárka, Balog Piroska, Vargha Péter, Gál János, Contrada Richard J, Falger Paul R J, Székely Andrea
机构信息
The Department of Anesthesia and Intensive Care, Semmelweis University, Budapest, Hungary.
出版信息
BMC Cardiovasc Disord. 2014 Nov 29;14:171. doi: 10.1186/1471-2261-14-171.
BACKGROUND
Recently, a considerable amount of evidence suggested that anxiety, depression and other psychosocial variables might influence the outcomes of cardiac surgery. This study investigated the relationship between length of stay at the intensive care unit (ICU) and hospital after surgery and different psychosocial variables (e.g. depression, anxiety, self rated health, happiness, satisfaction).
METHODS
We enrolled prospective patients who were waiting for elective cardiac surgery (N = 267) and consented to take part in the study. We collected data of sociodemographic, medical and perioperative factors as well as psychosocial questionnaires completed 1.56 days (standard deviation [SD] = 0.7) before surgery. The primary clinical endpoint was an ICU stay of at least 3 days and the secondary was hospital stay of at least 10 days.
RESULTS
Two hundred sixty-seven patients participated in this study. Four patients (1.5%) died in the hospital and 38 patients (14.5%) spent more than 3 days in the ICU and 62 patients (23.2%) spent more than 10 days in the hospital. After controlling for medical and sociodemographic factors, lower self rated health (Adjusted Odds Ratio [AOR]: 0.51, 95% confidence interval [CI]: 0.28-0.95; p = 0.03), lower rate of happiness (AOR: 0.76, 95% CI: 0.59-0.97, p = 0.03), postoperative cardiac failure (AOR: 7.09, 95% CI:1.21-41.54; p = 0.03) and postoperative complications (AOR: 9.52, 95% CI: 3.76-24.11; p < 0.001) were associated with longer ICU stay. More than 10 days of hospital stay was associated with higher occurrence of COPD (AOR 4.56, CI: 1.95-10.67, p < 0.001), NYHA stage (AOR 6.76, CI: 2.57-17.79, p < 0.001), operation time (AOR 1.45, CI: 1.19-1.76, p < 0.001), female gender (AOR 2.16, CI: 1.06-4.40, p = 0.034) and lower self-rated health (AOR 0.63, CI: 0.41-0.99, p = 0.044).
CONCLUSIONS
Lower happiness and self-rated health may influence the outcome of cardiac surgery. Therefore, these variables should be assessed in patients.
背景
最近，大量证据表明焦虑、抑郁和其他社会心理变量可能会影响心脏手术的结果。本研究调查了重症监护病房（ICU）住院时间和术后住院时间与不同社会心理变量（如抑郁、焦虑、自评健康状况、幸福感、满意度）之间的关系。
方法
我们招募了等待择期心脏手术的前瞻性患者（N = 267），并征得他们同意参与研究。我们收集了社会人口学、医学和围手术期因素的数据，以及术前1.56天（标准差[SD]=0.7）完成的社会心理调查问卷数据。主要临床终点是ICU住院至少3天，次要终点是住院至少10天。
结果
267名患者参与了本研究。4名患者（1.5%）在医院死亡，38名患者（14.5%）在ICU住院超过3天，62名患者（23.2%）住院超过10天。在控制了医学和社会人口学因素后，较低的自评健康状况（调整优势比[AOR]：0.51，95%置信区间[CI]：0.28 - 0.95；p = 0.03）、较低的幸福率（AOR：0.76，95% CI：0.59 - 0.97，p = 0.03）、术后心力衰竭（AOR：7.09，95% CI：1.21 - 41.54；p = 0.03）和术后并发症（AOR：9.52，95% CI：3.76 - 24.11；p < 0.001）与ICU住院时间延长有关。住院超过10天与慢性阻塞性肺疾病（COPD）发生率较高（AOR 4.56，CI：1.95 - 10.67，p < 0.001）、纽约心脏协会（NYHA）分级（AOR 6.76，CI：2.57 - 17.79，p < 0.001）、手术时间（AOR 1.45，CI：1.19 - 1.76，p < 0.001）、女性性别（AOR 2.16，CI：1.06 - 4.40，p = 0.034）和较低的自评健康状况（AOR 0.63，CI：0.41 - 0.99，p = 0.044）有关。
结论
较低的幸福感和自评健康状况可能会影响心脏手术的结果。因此，应对患者的这些变量进行评估。
Zotero 插件