Department of Cardiac Surgery, Michigan Medicine, Ann Arbor, Michigan.
Department of General Surgery, St. Joseph Mercy, Ann Arbor, Michigan.
Semin Thorac Cardiovasc Surg. 2022 Summer;34(2):399-407. doi: 10.1053/j.semtcvs.2021.03.040. Epub 2021 May 11.
This study aimed to determine how acute type A aortic dissection (ATAAD) impacts patients' quality of life. The 36-Item Short Form Survey (SF-36) was used to measure quality of life. The eight SF-36 scales were aggregated into a two-factor summary: physical and mental component summary scales (PCS and MCS). One hundred fourteen patients were included in the ATAAD group and 81 patients in the aortic valve replacement (AVR) group. All patients underwent surgery between June 2007 and December 2018. Surveys were completed after the operation. The mean scaled score of the ATAAD group decreased significantly in all eight domains of the SF-36 survey after aortic dissection repair except mental health. Also, the postsurgery PCS score was significantly lower than the presurgery score (39 vs 49; P < 0.0001). Multivariable regression confirmed the negative impact of ATAAD on postsurgery PCS score and higher presurgery PCS score had a significant positive impact. The postsurgery MCS score did not change significantly (49 vs 50; P = 0.32), but higher preoperative MCS score had a significant positive impact on the postsurgery MCS score. Age, sex, connective tissue disorders, and stroke did not contribute significantly to the postsurgery PCS and MCS scores. The AVR group had significantly increased postsurgery PCS and MCS scores compared to the presurgery scores (47 vs 41; P < 0.0001) and (53 vs 51; P = 0.02) respectively. Patients reported significantly decreased physical health after recovery from acute type A aortic dissection repair. A multidisciplinary approach is needed to improve patients' quality of life.
本研究旨在探讨急性A型主动脉夹层(ATAAD)对患者生活质量的影响。采用 36 项简短健康调查问卷(SF-36)来评估生活质量。8 个 SF-36 量表被综合为两个因子总分:生理和心理成分量表(PCS 和 MCS)。ATAAD 组纳入 114 例患者,主动脉瓣置换术(AVR)组纳入 81 例患者。所有患者均于 2007 年 6 月至 2018 年 12 月期间接受手术。术后完成问卷调查。ATAAD 组在主动脉夹层修复后,SF-36 调查的所有 8 个领域的评分均值均显著下降,除心理健康外。此外,术后 PCS 评分显著低于术前(39 分比 49 分;P<0.0001)。多变量回归证实 ATAAD 对术后 PCS 评分有负面影响,而较高的术前 PCS 评分对术后 PCS 评分有显著的正向影响。术后 MCS 评分无显著变化(49 分比 50 分;P=0.32),但较高的术前 MCS 评分对术后 MCS 评分有显著的正向影响。年龄、性别、结缔组织疾病和卒中对术后 PCS 和 MCS 评分无显著影响。与术前相比,AVR 组术后 PCS 和 MCS 评分均显著升高(47 分比 41 分;P<0.0001)和(53 分比 51 分;P=0.02)。患者报告在急性 A 型主动脉夹层修复后恢复期身体健康明显下降。需要采取多学科方法来提高患者的生活质量。