Assmann Anna Kathrin, Assmann Alexander, Waßenberg Sebastian, Kojcici Besnik, Schaal Nora K, Lichtenberg Artur, Ennker Jürgen, Albert Alexander
Department of Cardiac Surgery, Heinrich Heine University, Medical Faculty, Duesseldorf, Germany.
punkt05 Statistics Consultants, Life Science Centre, Duesseldorf, Germany.
Interdiscip Cardiovasc Thorac Surg. 2023 Feb 6;36(2). doi: 10.1093/icvts/ivad014.
To achieve a beneficial impact on long-term outcome after coronary artery bypass grafting (CABG), the goal of the present study was the early identification of patients at risk of impaired postoperative health-related quality of life (HRQoL), particularly evaluating the significance of socio-demographic variables.
In this prospective, single-centre cohort study of patients having an isolated CABG (January 2004-December 2014), preoperative socio-demographic (preSOC) and preoperative medical variables as well as 6-month follow-up data including the Nottingham Health Profile were analysed in 3,237 patients.
All preSOC (gender, age, marriage and employment) and follow-up (chest pain, dyspnoea) variables proved to have significant influence on HRQoL (P < 0.001), male patients below 60 years being particularly impaired. The effects of marriage and employment on HRQoL are modulated by age and gender. The significance of the predictors of reduced HRQoL differs between the 6 Nottingham Health Profile domains. Multivariable regression analyses revealed explained proportions of variance amounting to 7% for preSOC and 4% for preoperative medical variables.
The identification of patients at risk of impaired postoperative HRQoL is decisive for providing additional support. This study reveals that the assessment of 4 preoperative socio-demographic characteristics (age, gender, marriage, employment) is more predictive of HRQoL after CABG than are multiple medical variables.
为了对冠状动脉旁路移植术（CABG）后的长期预后产生有益影响，本研究的目标是早期识别术后健康相关生活质量（HRQoL）受损风险的患者，尤其评估社会人口统计学变量的重要性。
在这项对接受单纯CABG手术患者（2004年1月至2014年12月）的前瞻性单中心队列研究中，分析了3237例患者的术前社会人口统计学（preSOC）和术前医学变量以及包括诺丁汉健康量表在内的6个月随访数据。
所有preSOC（性别、年龄、婚姻状况和就业情况）和随访（胸痛、呼吸困难）变量均被证明对HRQoL有显著影响（P < 0.001），60岁以下男性患者受影响尤为严重。婚姻和就业对HRQoL的影响受年龄和性别的调节。HRQoL降低的预测因素在诺丁汉健康量表的6个领域中有所不同。多变量回归分析显示，preSOC变量可解释的方差比例为7%，术前医学变量为4%。
识别术后HRQoL受损风险的患者对于提供额外支持至关重要。本研究表明，评估4个术前社会人口统计学特征（年龄、性别、婚姻、就业）比多个医学变量更能预测CABG术后的HRQoL。
