Department of Cardiothoracic Surgery, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
Netherlands Heart Registry, Utrecht, Netherlands.
Eur J Cardiothorac Surg. 2019 Sep 1;56(3):526-533. doi: 10.1093/ejcts/ezz051.
In this study, our aim was to explore how coronary artery bypass grafting affects quality of life, and how this varies with age, particularly with patients at risk of deterioration.
In a retrospective, multicentre cohort study, patients with isolated coronary artery bypass grafting and electively operated between January 2011 and January 2015 with pre- and postoperative quality-of-life data were included. Patients were classified into 3 age groups: <65, 65-79 and ≥80 years. Quality of life was measured up to 1-year follow-up using the Short Form-12 or the Short Form-36 health survey. A multivariable, linear regression analysis, with an adjustment for confounders, was used to evaluate the association between age and quality of life.
A total of 2606 patients were included in this study. Upon one-year of follow-up, the mean physical health of patients increased from 54 at baseline to 68, and mental health increased from 60 to 67. We observed decreased mental health in 20% of patients aged <65 years, 20% of patients aged 65-79 years and 29% of patients aged ≥80 years (P = 0.039). In this study, age was not associated with a lower physical or mental component score (P = 0.054 and P = 0.13, respectively). Independent risk factors for a decrease in quality of life consist of a better physical and mental score at baseline (P < 0.001) and a reduced left ventricular function (P < 0.001).
Most patients experience a relevant increase in physical and mental quality of life, but a proportion of patients aged ≥80 years undergo significant deterioration in mental health.
本研究旨在探讨冠状动脉旁路移植术对生活质量的影响，以及这种影响如何随年龄变化，尤其是在存在恶化风险的患者中。
在一项回顾性、多中心队列研究中，纳入了 2011 年 1 月至 2015 年 1 月间择期行单纯冠状动脉旁路移植术且具有术前和术后生活质量数据的患者。患者被分为 3 个年龄组：<65 岁、65-79 岁和≥80 岁。使用简明健康状况调查问卷（Short Form-12 或 Short Form-36 健康调查）在术后 1 年的随访期间测量生活质量。采用多变量线性回归分析，对混杂因素进行调整，以评估年龄与生活质量之间的关系。
共纳入 2606 例患者。在 1 年的随访期间，患者的身体健康状况从基线时的 54 分增加到 68 分，心理健康状况从 60 分增加到 67 分。我们观察到，<65 岁的患者中有 20%、65-79 岁的患者中有 20%和≥80 岁的患者中有 29%的心理健康状况下降（P=0.039）。在本研究中，年龄与较低的生理或心理成分评分无关（P=0.054 和 P=0.13，分别）。生活质量下降的独立危险因素包括基线时较好的生理和心理健康评分（P<0.001）和左心室功能下降（P<0.001）。
大多数患者的生理和心理健康质量都有明显提高，但≥80 岁的患者中有一部分的心理健康状况显著恶化。
