心力衰竭患者的健康相关生活质量、功能状态及无心脏事件生存期
Health-Related Quality of Life, Functional Status, and Cardiac Event-Free Survival in Patients With Heart Failure.
作者信息
Wu Jia-Rong, Lennie Terry A, Frazier Susan K, Moser Debra K
机构信息
Jia-Rong Wu, PhD, RN Assistant Professor, School of Nursing, University of North Carolina at Chapel Hill.Terry A. Lennie, PhD, RN Professor, College of Nursing, University of Kentucky, Lexington.Susan K. Frazier, PhD, RN Associate Professor, College of Nursing, University of Kentucky, Lexington.Debra K. Moser, DNSc, RN Professor, College of Nursing, University of Kentucky, Lexington.
出版信息
J Cardiovasc Nurs. 2016 May-Jun;31(3):236-44. doi: 10.1097/JCN.0000000000000248.
BACKGROUND
Health-related quality of life (HRQOL), functional status, and cardiac event-free survival are outcomes used to assess the effectiveness of interventions in patients with heart failure (HF). However, the nature of the relationships among HRQOL, functional status, and cardiac event-free survival remains unclear.
OBJECTIVE
The purpose of this study is to examine the nature of the relationships among HRQOL, functional status, and cardiac event-free survival in patients with HF.
METHODS
This was a prospective, observational study of 313 patients with HF that was a secondary analysis from a registry. At baseline, patient demographic and clinical data were collected. Health-related quality of life was assessed using the Minnesota Living With Heart Failure Questionnaire and functional status was measured using the Duke Activity Status Index. Cardiac event-free survival data were obtained by patient interview, hospital database, and death certificate review. Multiple linear and Cox regressions were used to explore the relationships among HRQOL, functional status, and cardiac event-free survival while adjusting for demographic and clinical factors.
RESULTS
Participants (n = 313) were men (69%), white (79%), and aged 62 ± 11 years. Mean left ventricular ejection fraction was 35% ± 14%. The mean HRQOL score of 32.3 ± 20.6 indicated poor HRQOL. The mean Duke Activity Status Index score of 16.2 ± 12.9 indicated poor functional status. Cardiac event-free survival was significantly worse in patients who had worse HRQOL or poorer functional status. Patients who had better functional status had better HRQOL (P < .001). Health-related quality of life was not a significant predictor of cardiac event-free survival after entering functional status in the model (P = .54), demonstrating that it was a mediator of the relationship between HRQOL and outcome.
CONCLUSION
Functional status was a mediator between HRQOL and cardiac event-free survival. These data suggest that intervention studies to improve functional status are needed.
背景
健康相关生活质量（HRQOL）、功能状态和无心脏事件生存期是用于评估心力衰竭（HF）患者干预措施有效性的指标。然而，HRQOL、功能状态和无心脏事件生存期之间关系的本质仍不明确。
目的
本研究旨在探讨HF患者中HRQOL、功能状态和无心脏事件生存期之间关系的本质。
方法
这是一项对313例HF患者进行的前瞻性观察性研究，是对一个登记处数据的二次分析。在基线时，收集患者的人口统计学和临床数据。使用明尼苏达心力衰竭生活问卷评估健康相关生活质量，使用杜克活动状态指数测量功能状态。通过患者访谈、医院数据库和死亡证明审查获得无心脏事件生存期数据。在调整人口统计学和临床因素的同时，使用多元线性回归和Cox回归来探讨HRQOL、功能状态和无心脏事件生存期之间的关系。
结果
参与者（n = 313）为男性（69%）、白人（79%），年龄62±11岁。平均左心室射血分数为35%±14%。HRQOL平均得分为32.3±20.6，表明HRQOL较差。杜克活动状态指数平均得分为16.2±12.9，表明功能状态较差。HRQOL较差或功能状态较差的患者无心脏事件生存期明显更差。功能状态较好的患者HRQOL更好（P <.001）。在模型中纳入功能状态后，健康相关生活质量不是无心脏事件生存期的显著预测因素（P =.54），表明它是HRQOL与结局之间关系的中介因素。
结论
功能状态是HRQOL和无心脏事件生存期之间的中介因素。这些数据表明需要开展改善功能状态的干预研究。
Zotero 插件