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接受导管消融术的心房颤动患者症状及健康相关生活质量的性别和年龄差异

Gender and age differences in symptoms and health-related quality of life in patients with atrial fibrillation referred for catheter ablation.

作者信息

Walfridsson Ulla, Steen Hansen Peter, Charitakis Emmanouil, Almroth Henrik, Jönsson Anders, Karlsson Lars O, Liuba Ioan, Samo Ayou Romeo, Poci Dritan, Holmqvist Fredrik, Kongstad Ole, Walfridsson Håkan

机构信息

Department of Cardiology and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.

Private Hospital Molholm, Vejle, Denmark.

出版信息

Pacing Clin Electrophysiol. 2019 Nov;42(11):1431-1439. doi: 10.1111/pace.13795. Epub 2019 Sep 24.

Abstract

BACKGROUND

Primary indication for catheter ablation of atrial fibrillation (AF) is to reduce symptoms and improve health-related quality of life (HRQoL). There are data showing differences between the genders and between younger and older patients. To evaluate this, we studied a large Scandinavian cohort of patients referred for catheter ablation of AF.

METHODS

Consecutive patients filled out the ASTA questionnaire, assessing symptoms, HRQoL, and perception of arrhythmia, prior to ablation. Patients were recruited from four Swedish and one Danish tertiary center.

RESULTS

A total of 2493 patients (72% men) filled out the ASTA questionnaire. Women experienced eight of the nine ASTA scale symptoms more often than men. Patients <65 years reported four symptoms more often, only tiredness was more frequent in those ≥65 years (P = .007). Women and patients <65 years experienced more often palpitations and regarding close to fainting and this was more common among women, no age differences were seen. Women and men scored differently in 10 of the 13 HRQoL items. Only negative impact on sexual life was more common in men (P < .001). Older patients reported more negative influence in four of the HRQoL items and the younger in one; ability to concentrate.

CONCLUSIONS

Women experienced a more pronounced symptom burden and were more negatively affected in all HRQoL concerns, except for the negative impact on sexual life, where men reported more influence of AF. Differences between age groups were less pronounced. Disease-specific patient-reported outcomes measures (PROMs) add important information where gender differences should be considered in the care.

摘要

背景

心房颤动(AF)导管消融的主要指征是减轻症状并改善健康相关生活质量(HRQoL)。有数据显示性别之间以及年轻与老年患者之间存在差异。为了对此进行评估,我们研究了一大群被转诊进行AF导管消融的斯堪的纳维亚患者。

方法

连续的患者在消融术前填写ASTA问卷,评估症状、HRQoL和对心律失常的感知。患者来自四个瑞典和一个丹麦的三级中心。

结果

共有2493名患者(72%为男性)填写了ASTA问卷。女性比男性更频繁地经历ASTA量表中的九种症状中的八种。年龄<65岁的患者更频繁地报告四种症状,只有疲倦在≥65岁的患者中更常见(P = 0.007)。女性和年龄<65岁的患者更频繁地经历心悸以及接近昏厥的情况,并且这种情况在女性中更常见,未观察到年龄差异。在13项HRQoL项目中的10项中,女性和男性的得分不同。只有对性生活的负面影响在男性中更常见(P < 0.001)。老年患者在四项HRQoL项目中报告了更多负面影响,而年轻患者在一项中报告了更多负面影响;即集中注意力的能力。

结论

女性经历了更明显的症状负担,并且在所有HRQoL方面受到的负面影响更大,但对性生活的负面影响除外,在这方面男性报告AF的影响更大。年龄组之间的差异不太明显。特定疾病的患者报告结局指标(PROMs)增加了重要信息,在护理中应考虑性别差异。

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