Borregaard Britt, Ekholm Ola, Riber Lars, Sørensen Jan, Møller Jacob E, Thrysoe Lars, Thorup Charlotte B, Vámosi Marianne, Christensen Anne V, Rasmussen Trine B, Berg Selina K
1 Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Denmark.
2 National Institute of Public Health, University of Southern Denmark, Denmark.
Eur J Cardiovasc Nurs. 2018 Mar;17(3):246-254. doi: 10.1177/1474515117731391. Epub 2017 Sep 11.
Clinical course, co-morbidity and age often differs between patients undergoing aortic and mitral valve surgery and this might affect patient-reported outcomes.
The purpose of this study was to describe differences in patient-reported physical and mental health and health-related quality of life after aortic valve or mitral valve surgery, and to identify demographic and clinical characteristics associated with worse patient-reported physical and mental health, and health-related quality of life.
Patient-reported outcomes were measured at discharge as a part of a national, cross-sectional study (DenHeart). Patient-reported outcome measures included: Short-Form-12, Hospital Anxiety and Depression Scale, EuroQol-5D-5L, HeartQol and Edmonton Symptom Assessment System. Demographic and clinical information was obtained from national registers.
Of 354 patients (65% men, mean age: 68 years), 79% underwent aortic valve surgery. Patients who had undergone aortic valve surgery had more symptoms of anxiety compared with patients who had undergone mitral valve surgery (34% vs 17%, p=0.003, Hospital Anxiety and Depression Scale anxiety cut-off score of eight). Being female was associated with worse patient-reported outcomes on all measures, whereas being unmarried was associated with worse physical health (Physical Component Score Short-Form-12) and symptom burden (Edmonton Symptom Assessment System). Length of stay was associated with worse symptoms on EuroQol-5D-5L Visual Analogue Scale. Age and comorbidity were not associated with patient-reported outcomes.
Patients who had undergone aortic valve and mitral valve surgery did not significantly differ in patient-reported health at discharge, except for symptoms of anxiety. Being female was the only characteristic associated with overall worse patient-reported outcomes at discharge.
接受主动脉瓣和二尖瓣手术的患者在临床病程、合并症和年龄方面往往存在差异，这可能会影响患者报告的结局。
本研究的目的是描述主动脉瓣或二尖瓣手术后患者报告的身心健康及健康相关生活质量的差异，并确定与患者报告的较差身心健康及健康相关生活质量相关的人口统计学和临床特征。
作为一项全国性横断面研究（丹麦心脏研究）的一部分，在出院时测量患者报告的结局。患者报告的结局指标包括：简明健康调查问卷-12、医院焦虑抑郁量表、欧洲五维健康量表-5D-5L、心脏生活质量量表和埃德蒙顿症状评估系统。人口统计学和临床信息从国家登记处获取。
在354例患者（65%为男性，平均年龄68岁）中，79%接受了主动脉瓣手术。与接受二尖瓣手术的患者相比，接受主动脉瓣手术的患者焦虑症状更多（34%对17%，p=0.003，医院焦虑抑郁量表焦虑临界值为8分）。女性在所有指标上均与较差的患者报告结局相关，而未婚与较差的身体健康（简明健康调查问卷-12身体成分得分）和症状负担（埃德蒙顿症状评估系统）相关。住院时间与欧洲五维健康量表-5D-5L视觉模拟量表上较差的症状相关。年龄和合并症与患者报告的结局无关。
除焦虑症状外，接受主动脉瓣和二尖瓣手术的患者在出院时报告的健康状况无显著差异。女性是唯一与出院时总体较差的患者报告结局相关的特征。
