Division of Health Informatics, Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, NY, USA.
Bristol Heart Institute, University of Bristol, Bristol, UK.
Eur Heart J Qual Care Clin Outcomes. 2022 May 5;8(3):259-268. doi: 10.1093/ehjqcco/qcab075.
We conducted a systematic review and meta-analysis to evaluate temporal trends in quality of life (QoL) after coronary artery bypass grafting (CABG) surgery in randomized clinical trials, and a quantitative comparison from before surgery to up to 5 years after surgery.
We searched MEDLINE, CINAHL, EMBASE, Cochrane Library, and PsycINFO from 2010 to 2020 to identify studies that included the measurement of QoL in patients undergoing CABG. The primary outcome was the Seattle Angina Questionnaire (SAQ), and secondary outcomes were the 36-item Short Form Health Survey (SF-36) and EuroQol Questionnaire (EQ-5D). We pooled the means and the weighted mean differences over the follow-up period. In the meta-analysis, 2586 studies were screened and 18 full-text studies were included. There was a significant trend towards higher QoL scores from before surgery to 1 year post-operatively for the SAQ angina frequency (AF), SAQ QoL, SF-36 physical component (PC), and EQ-5D, whereas the SF-36 mental component (MC) did not improve significantly. The weighted mean differences from before surgery to 1 year after was 24 [95% confidence interval (CI): 21.6-26.4] for the SAQ AF, 31 (95% CI: 27.5-34.6) for the SAQ QoL, 9.8 (95% CI: 7.1-12.8) for the SF-36 PC, 7.1 (95% CI: 4.2-10.0) for the SF-36 MC, and 0.1 (95% CI: 0.06-0.14) for the EQ-5D. There was no evidence of publication bias or small-study effect.
CABG had both short- and long-term improvements in disease-specific QoL and generic QoL, with the largest improvement in angina frequency.
我们进行了一项系统评价和荟萃分析，以评估随机临床试验中冠状动脉旁路移植术（CABG）后生活质量（QoL）的时间趋势，并从手术前到手术后 5 年进行定量比较。
我们从 2010 年至 2020 年在 MEDLINE、CINAHL、EMBASE、Cochrane 图书馆和 PsycINFO 中搜索了包括 CABG 患者 QoL 测量的研究。主要结局是西雅图心绞痛问卷（SAQ），次要结局是 36 项简短健康调查问卷（SF-36）和 EuroQol 问卷（EQ-5D）。我们对随访期间的平均值和加权均数差值进行了汇总。荟萃分析中，共筛选出 2586 项研究，纳入了 18 项全文研究。SAQ 心绞痛发作频率（AF）、SAQ 生活质量、SF-36 生理成分（PC）和 EQ-5D 从术前到术后 1 年呈显著上升趋势，而 SF-36 心理成分（MC）无明显改善。从术前到术后 1 年的加权均数差值为 SAQ AF 24 [95%置信区间（CI）：21.6-26.4]、SAQ 生活质量 31（95% CI：27.5-34.6）、SF-36 PC 9.8（95% CI：7.1-12.8）、SF-36 MC 7.1（95% CI：4.2-10.0）和 EQ-5D 0.1（95% CI：0.06-0.14）。未发现发表偏倚或小样本效应。
CABG 可改善疾病特异性 QoL 和一般 QoL，短期和长期均有改善，心绞痛发作频率改善最大。
