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衰弱综合征和痴呆对老年房颤患者口服抗凝治疗便利性和满意度的影响。

The Influence of Frailty Syndrome and Dementia on the Convenience and Satisfaction with Oral Anticoagulation Treatment in Elderly Patients with Atrial Fibrillation.

机构信息

Department of Clinical Nursing, Medical University, 51-618 Wroclaw, Poland.

Department of Cardiology, T. Marciniak Hospital, 54-049 Wroclaw, Poland.

出版信息

Int J Environ Res Public Health. 2022 Apr 28;19(9):5355. doi: 10.3390/ijerph19095355.

Abstract

Background: The impact of frailty syndrome (FS) and dementia on the convenience and satisfaction with oral anticoagulation (OAC) treatment in atrial fibrillation (AF) patients is not well-known. Aim: Assessment the impact of FS and dementia on the convenience and satisfaction with OAC treatment in 116 elderly (mean age 75.2, SD = 8.2) patients with AF. Methodology: A self-administered questionnaire was used in the study to collect basic socio-demographic and clinical data. Tilburg Frailty Indicator (TFI) questionnaire was used to assess the presence of FS, Mini Mental State Examination (MMSE) to assess cognitive impairment (CI), The Perception of Anticoagulant Treatment Questionnaire Part 2 (PACT-Q2) to assess convenience and satisfaction with OAC treatment, and the Arrhythmia-Specific Questionnaire in Tachycardia and Arrhythmia (ASTA) to assess quality of life (QoL). Results: Multivariable analysis as a significant, negative predictor of the convenience and satisfaction domain showed the occurrence of dementia (β = −0.34; p < 0.001, β = −0.41; p < 0.001, respectively) and prior major bleeding (β = −0.30; p < 0.001, β = −0.33; p < 0.001, respectively). Analysis showed a significant relationship between convenience and satisfaction and the overall result of the ASTA (r = −0.329; p < 0.001, r = −0.372; p < 0.001, respectively). Conclusions: Elements of geriatric syndrome, such as FS and dementia, adversely affect treatment convenience and satisfaction with OAC treatment in AF. It has been shown that better convenience and satisfaction with OAC treatment translates into better QoL. There were no differences between satisfaction and convenience and the type of OAC treatment (vitamin K antagonists (VKA) vs. novel oral anticoagulants (NOAC).

摘要

背景

衰弱综合征(FS)和痴呆症对房颤(AF)患者口服抗凝治疗(OAC)的便利性和满意度的影响尚不清楚。目的:评估 FS 和痴呆症对 116 名老年(平均年龄 75.2,SD=8.2)AF 患者 OAC 治疗的便利性和满意度的影响。方法:本研究采用自填式问卷收集基本社会人口学和临床数据。使用 Tilburg 衰弱指标(TFI)问卷评估 FS 的存在,使用简易精神状态检查(MMSE)评估认知障碍(CI),使用抗凝治疗感知问卷第二部分(PACT-Q2)评估 OAC 治疗的便利性和满意度,以及心律失常特异性心动过速和心律失常问卷(ASTA)评估生活质量(QoL)。结果:多变量分析作为便利性和满意度领域的显著负预测因素,显示痴呆症(β=-0.34;p<0.001,β=-0.41;p<0.001)和既往大出血(β=-0.30;p<0.001,β=-0.33;p<0.001)的发生。分析显示便利性和满意度与 ASTA 的总体结果呈显著相关(r=-0.329;p<0.001,r=-0.372;p<0.001)。结论:老年综合征的要素,如 FS 和痴呆症,会对 AF 患者的 OAC 治疗便利性和满意度产生不利影响。已经表明,更好的 OAC 治疗便利性和满意度会转化为更好的生活质量。在 OAC 治疗类型(维生素 K 拮抗剂(VKA)与新型口服抗凝剂(NOAC))之间,满意度和便利性没有差异。

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