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与起搏器共同生活:起搏器系统的患者报告结局

Living with a pacemaker: patient-reported outcome of a pacemaker system.

作者信息

Magnusson Peter, Liv Per

机构信息

Cardiology Research Unit, Department of Medicine, Karolinska Institutet, Karolinska University Hospital/Solna, SE-171 76, Stockholm, Sweden.

Centre for Research and Development, Uppsala University/Region Gävleborg, Gävle, Sweden.

出版信息

BMC Cardiovasc Disord. 2018 Jun 4;18(1):110. doi: 10.1186/s12872-018-0849-6.

Abstract

BACKGROUND

The aim of this study was to assess among pacemaker patients their overall satisfaction with the pacemaker system, pain, soreness/discomfort, cosmetic results, restrictions due to impaired movement of the shoulder/arm/chest, related sleep disturbances, and concern about possible device malfunction.

METHODS

The seven-item questionnaire was mailed to patients from a single center who had a pacemaker implant or replacement between 2006 and 2016. A higher score indicated worse outcome on a visual analog scale (VAS) of 0-100 mm.

RESULTS

The response rate was 75.5% and 342 questionniares were analyzed. Median age of respondents was 77.6 years and 57.0% were males. In total, 65 complications requiring surgery (10 pocket corrections (2.9%), 5 in females) occurred during a median follow-up of 5.6 years.The distribution of the primary outcome had a median score of 5 while the 75th percentile was 13. Cosmetic appearance was significantly associated with reoperation (but not other variables). Overall scores for men and women were 5 vs. 6, respectively, which achieved significance (p = 0.042). Median ratings of pain, soreness/discomfort, cosmetic appearance, range of motion, sleep, and concern about device malfunction were all ≤5. Females reported worse outcomes for all questions, except for cosmetic results and concern about malfunction.

CONCLUSIONS

The vast majority of patients report excellent overall satisfaction with the pacemaker system, and are not affected by pain, soreness/discomfort, or concern about device malfunction. They also reported favourable outcomes with respect to cosmetic results, shoulder movement, and sleep. However, some patients underwent a surgical correction of the pacemaker pocket.

摘要

背景

本研究旨在评估起搏器患者对起搏器系统的总体满意度、疼痛、酸痛/不适、外观效果、因肩部/手臂/胸部活动受限导致的限制、相关睡眠障碍以及对设备可能出现故障的担忧。

方法

向来自单一中心的2006年至2016年间植入或更换起搏器的患者邮寄了一份包含七个项目的问卷。较高的分数表明在0至100毫米的视觉模拟量表(VAS)上结果更差。

结果

回复率为75.5%,共分析了342份问卷。受访者的中位年龄为77.6岁,男性占57.0%。在中位随访5.6年期间,共发生65例需要手术的并发症(10例囊袋矫正(2.9%),其中女性5例)。主要结局的分布中位数为5分,第75百分位数为13分。外观与再次手术显著相关(但与其他变量无关)。男性和女性的总体得分分别为5分和6分,具有显著性差异(p = 0.042)。疼痛、酸痛/不适、外观、活动范围、睡眠以及对设备故障的担忧的中位评分均≤5分。除外观效果和对故障的担忧外,女性在所有问题上报告的结果更差。

结论

绝大多数患者对起搏器系统总体满意度极高,且不受疼痛、酸痛/不适或对设备故障的担忧影响。他们在外观效果、肩部活动和睡眠方面也报告了良好的结果。然而,一些患者接受了起搏器囊袋的手术矫正。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1dc8/5987385/db09712bcca7/12872_2018_849_Fig1_HTML.jpg

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