生活质量与心房颤动患者的衰弱综合征。
Quality of Life and Frailty Syndrome in Patients with Atrial Fibrillation.
机构信息
Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Wrocław, Poland.
Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wrocław, Poland.
出版信息
Clin Interv Aging. 2020 May 29;15:783-795. doi: 10.2147/CIA.S248170. eCollection 2020.
INTRODUCTION
Atrial fibrillation (AF) and frailty syndrome (FS) are a part of the aging process. Both are still of great importance in the assessment of quality of life (QoL). There is definitely a lack of research clarifying the association between FS and QoL in AF patients.
OBJECTIVE
The aim of this study was to evaluate the influence of FS on QoL in AF patients.
MATERIALS AND METHODS
The retrospective and observational study included 158 inpatients with mean age 69.8±7.1 years, treated for AF in the cardiac department from 1 April 2019 to 31 June 2019. The following instruments were used: the Arrhythmia-Specific Questionnaire in Tachycardia and Arrhythmia (ASTA) and the Edmonton Frail Scale (EFS).
RESULTS
The mean level of frailty in the study group was 8.5±5.0. In 25.9% of patients, the level of frailty was mild, in 10.1% moderate, and in 17.1% severe. Patients were divided into two groups based on their frailty status. In comparative analysis of the QoL, there were significant differences between the groups: the frail group had more intense symptoms of arrhythmia than the non-frail group (14.9±4.1 vs 11.9±4.9; <0.001). In the analysis of the total score impact of arrhythmia on QoL, the frail group had a significantly higher score than the non-frail group (23.5±5.2 vs 14.5±5.5), which confirmed the stronger negative impact of arrhythmia on QoL. In the regression coefficient analysis, the independent predictor of symptom severity and QoL was FS. However, we observed a negative impact of diabetes, which increased the impact of arrhythmia on QoL, and physical activity, which improved QoL and decreased the impact of symptoms on everyday life.
CONCLUSION
Patients in the frail group have worse QoL and higher impact of arrhythmia on QoL in comparison to patients in the non-frail group. Frailty is an independent predictor of higher intensity of symptoms of arrhythmia and worse QoL. Diabetes and physical activity are predictors of QoL for patients with AF.
简介
心房颤动（AF）和衰弱综合征（FS）是衰老过程的一部分。在生活质量（QoL）评估中，两者仍然非常重要。目前，明确 FS 与 AF 患者 QoL 之间关联的研究还很缺乏。
目的
本研究旨在评估 FS 对 AF 患者 QoL 的影响。
材料和方法
本回顾性观察性研究纳入了 158 名平均年龄 69.8±7.1 岁的住院患者，这些患者在 2019 年 4 月 1 日至 6 月 31 日期间在心内科因 AF 接受治疗。研究中使用了心律失常特定问卷心动过速和心律失常（ASTA）和埃德蒙顿衰弱量表（EFS）。
结果
研究组的平均衰弱程度为 8.5±5.0。25.9%的患者衰弱程度较轻，10.1%的患者衰弱程度为中度，17.1%的患者衰弱程度严重。根据衰弱状况将患者分为两组。在 QoL 的对比分析中，两组之间存在显著差异：衰弱组的心律失常症状比非衰弱组更严重（14.9±4.1 对 11.9±4.9；<0.001）。在分析心律失常对 QoL 的总评分影响时，衰弱组的评分明显高于非衰弱组（23.5±5.2 对 14.5±5.5），这证实了心律失常对 QoL 的负面影响更强。在回归系数分析中，FS 是症状严重程度和 QoL 的独立预测因子。然而，我们观察到糖尿病的负面影响增加了心律失常对 QoL 的影响，而身体活动则改善了 QoL 并降低了症状对日常生活的影响。
结论
与非衰弱组患者相比，衰弱组患者的 QoL 更差，心律失常对 QoL 的影响更大。衰弱是心律失常症状严重程度和 QoL 较差的独立预测因子。糖尿病和身体活动是 AF 患者 QoL 的预测因子。
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