Raymakers Adam J N, Gillespie Paddy, Murphy Edel, Cupples Margaret E, Smith Susan M, Murphy Andrew W, Griffin Matthew D, Benyamini Yael, Byrne Molly
CÚRAM SFI Centre for Research in Medical Devices, National University of Ireland Galway, Galway, Ireland.
Health Economics and Policy Analysis Centre, Department of Economics, National University of Ireland Galway, Galway, Ireland.
Fam Pract. 2018 Mar 27;35(2):172-178. doi: 10.1093/fampra/cmx094.
Patients with coronary heart disease (CHD) experience reduced quality of life which may be associated with mortality in the longer term. This study explores whether patient-rated physical and mental health status was associated with mortality at 6-year follow-up among patients with CHD attending primary care in Ireland and Northern Ireland.
This study is a secondary data analysis of patients with CHD recruited to a cluster randomized controlled trial from 2004 to 2010. Data collected included patient-rated physical component summary (PCS) and mental component summary (MCS) scores of health status (from the 12-Item Short-Form Health Survey (SF-12)), demographics and clinical parameters at baseline, and all-cause mortality at 6-year follow-up. Multivariate regression was conducted using generalized estimating equations (GEE) with a log-link function. Results are presented as odds ratios (ORs) and 95% confidence intervals (CIs).
The study consisted of 762 individuals with mean age 67.6 years [standard deviation (SD): 9.8], and was 29% female. Mean baseline SF-12 mental (MCS) and physical (PCS) component scores were 50.0 (SD: 10.8) and 39.6 (SD: 11.2), respectively. At 6-year follow-up, the adjusted OR for the baseline MCS for mortality was 0.97 (95% CI: 0.95-0.99) and for the PCS 0.97 (95% CI: 0.95-0.99). For every five-point increase in MCS and PCS scores, there was a 14% reduction in the likelihood of all-cause mortality.
Overall, the magnitude of effect for both mental health status and physical health status was similar; higher scores were significantly associated with a lower risk of mortality at 6-year follow-up.
冠心病（CHD）患者的生活质量下降，从长远来看这可能与死亡率相关。本研究探讨在爱尔兰和北爱尔兰接受初级保健的冠心病患者中，患者自评的身心健康状况与6年随访期死亡率之间是否存在关联。
本研究是对2004年至2010年招募到一项整群随机对照试验中的冠心病患者进行的二次数据分析。收集的数据包括患者自评的健康状况躯体成分总结（PCS）和精神成分总结（MCS）得分（来自12项简短健康调查问卷（SF - 12））、基线时的人口统计学和临床参数，以及6年随访期的全因死亡率。使用具有对数链接函数的广义估计方程（GEE）进行多变量回归分析。结果以比值比（OR）和95%置信区间（CI）表示。
该研究包括762名个体，平均年龄67.6岁[标准差（SD）：9.8]，女性占29%。基线时SF - 12精神（MCS）和躯体（PCS）成分的平均得分分别为50.0（SD：10.8）和39.6（SD：11.2）。在6年随访期，基线MCS对死亡率的调整后OR为0.97（95%CI：0.95 - 0.99），PCS为0.97（95%CI：0.95 - 0.99）。MCS和PCS得分每增加5分，全因死亡的可能性降低14%。
总体而言，心理健康状况和身体健康状况的影响程度相似；较高的得分与6年随访期较低的死亡风险显著相关。
