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与非瓣膜性心房颤动的年轻和老年泰国患者健康相关生活质量较低相关的因素。

Factors associated with low health-related quality of life among younger and older Thai patients with non-valvular atrial fibrillation.

机构信息

Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Police General Hospital, Bangkok, Thailand.

出版信息

Qual Life Res. 2019 Aug;28(8):2091-2098. doi: 10.1007/s11136-019-02171-3. Epub 2019 Apr 5.

Abstract

PURPOSE

The aim of this study was to investigate the factors associated with low health-related quality of life (HRQoL) compared between younger and older Thai patients with non-valvular atrial fibrillation (NVAF).

METHODS

This is a cross-sectional analysis of baseline data from a prospective NVAF registry from 24 hospitals located across Thailand. Patient demographic, clinical, lifestyle, and medication data were collected at baseline. EuroQOL/EQ-5D-3L was used to assess HRQoL. Health utility was calculated for the entire study population, and low HRQoL was defined as the lowest quartile. Multivariate logistic regression was used to identify factors that significantly predict low HRQoL among younger and older (≥ 65 years) patients with NVAF.

RESULTS

Among the 3218 participants that were enrolled, 61.0% were aged older than 65 years. Mean HRQoL was lower in older than in younger patients (0.72 ± 0.26 vs. 0.84 ± 0.20; p < 0.001). Factors associated with low HRQoL among younger NVAF patients were the treatment-related factors bleeding history (p = 0.006) and taking warfarin (p = 0.001). Among older patients, the NVAF-related complications ischemic stroke or TIA, heart failure (HF), and dementia (all p < 0.001) were all significantly associated with low HRQoL. Dementia is the factor that most adversely influences low HRQoL among older NVAF. Interestingly, symptomatic NVAF was found to be a protective factor for low HRQoL (p < 0.001).

CONCLUSIONS

Bleeding history and taking warfarin among younger patients, and ischemic stroke/TIA, HF, and dementia among older patients are significant predictors of low HRQoL. These factors should be taken into consideration when selecting treatment options for patients with NVAF.

摘要

目的

本研究旨在调查泰国年轻和老年非瓣膜性心房颤动(NVAF)患者之间与健康相关的生活质量(HRQoL)较低相关的因素。

方法

这是一项来自泰国 24 家医院的前瞻性 NVAF 登记处的基线数据的横断面分析。患者的人口统计学、临床、生活方式和药物数据在基线时收集。使用欧洲五维健康量表(EQ-5D-3L)评估 HRQoL。计算了整个研究人群的健康效用,并将 HRQoL 定义为最低四分位数。使用多变量逻辑回归来确定 NVAF 年轻(<65 岁)和老年(≥65 岁)患者中显著预测 HRQoL 较低的因素。

结果

在纳入的 3218 名参与者中,61.0%年龄大于 65 岁。老年患者的 HRQoL 均值低于年轻患者(0.72±0.26 与 0.84±0.20;p<0.001)。年轻 NVAF 患者 HRQoL 较低的相关因素是与治疗相关的因素,包括出血史(p=0.006)和服用华法林(p=0.001)。在老年患者中,NVAF 相关并发症缺血性卒中和短暂性脑缺血发作(TIA)、心力衰竭(HF)和痴呆(均 p<0.001)均与 HRQoL 较低显著相关。有趣的是,有症状的 NVAF 是 HRQoL 较低的保护因素(p<0.001)。

结论

年轻患者的出血史和服用华法林,以及老年患者的缺血性卒中和 TIA、HF 和痴呆是 HRQoL 较低的显著预测因素。在为 NVAF 患者选择治疗方案时,应考虑这些因素。

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