Alzahrani Abdulmajeed A, AlAssiri Abdullah K, Al-Ebrahim Khalid E, Ganbou Zeyad T, Alsudais Meshal M, Khafagy Abdulmajeed M
Cardiac Surgery, King Abdulaziz University Hospital, Jeddah, SAU.
Cardiac Surgery, King Abdulaziz University, Faculty of Medicine, Jeddah, SAU.
Cureus. 2024 Mar 23;16(3):e56781. doi: 10.7759/cureus.56781. eCollection 2024 Mar.
Coronary artery bypass grafting (CABG) is an essential surgical management modality for patients with coronary artery disease. Health-related quality of life (HRQoL) has become important because of the significant decrease in the mortality rate associated with CABG. We aimed to explore the factors that affect the quality of life after CABG.
This study used a descriptive correlational design to assess the determinants of HRQoL using the 36-item Short Form Health Survey questionnaire (SF-36). Patients who underwent CABG at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia, between March 2015 and December 2021 were enrolled in this study. Overall, 275 participants were eligible for our study, of which 84 were found to be valid for analysis. Phone contacts were made directly with the patient after briefly explaining the study. Scores and clinical data were investigated using multivariable linear regression analysis.
Subscales of role limitations due to physical issues had the lowest mean scores, followed by vitality and general health (57.4 ± 44.7; 60.4 ± 25.6; 64.1 ± 22.6), respectively. However, social functioning (78.9 ± 29.0) and pain (75.1 ± 29.9) had the highest scores of all subscales. A history of congestive heart failure (CHF) was independently associated with lower scores for physical role limitations (p = 0.021), vitality (p = 0.001), general health (p< 0.001), and mental health (p = 0.011). Lower mental health scores were also predicted by being a widow (p = 0.030), whereas lower general health scores were predicted by being unemployed (p = 0.001) and having a peripheral vascular disease (PVD) (p = 0.043). Additionally, the development of postoperative complications was an independent predictor of lower physical functioning (p = 0.028) and vitality (p = 0.043). Regarding the number of grafts, cardiopulmonary bypass, and cross-clamp time, no significant impact was found on any of the SF-36 subscales (p> 0.05).
The postoperative decline in HRQoL was attributed to comorbidities such as CHF and PVD, postoperative complications including bleeding and wound infection, as well as unemployment and widowed status. Therefore, choosing the appropriate patients for surgery and post-discharge follow-up may enhance HRQoL.
冠状动脉旁路移植术（CABG）是冠心病患者重要的外科治疗方式。由于CABG相关死亡率显著降低，健康相关生活质量（HRQoL）变得愈发重要。我们旨在探讨影响CABG术后生活质量的因素。
本研究采用描述性相关性设计，使用36项简明健康调查问卷（SF-36）评估HRQoL的决定因素。2015年3月至2021年12月期间在沙特阿拉伯吉达阿卜杜勒阿齐兹国王大学医院（KAUH）接受CABG手术的患者纳入本研究。总体而言，275名参与者符合我们的研究条件，其中84名被认为可用于分析。在简要解释研究内容后，直接与患者进行电话联系。使用多变量线性回归分析研究得分和临床数据。
因身体问题导致的角色限制分量表得分最低，其次是活力和总体健康（分别为57.4±44.7；60.4±25.6；64.1±22.6）。然而，社会功能（78.9±29.0）和疼痛（75.1±29.9）在所有分量表中得分最高。充血性心力衰竭（CHF）病史与身体角色限制得分较低独立相关（p = 0.021）、活力（p = 0.001）、总体健康（p<0.001）和心理健康（p = 0.011）。寡妇身份也预示着心理健康得分较低（p = 0.030），而失业（p = 0.001）和患有外周血管疾病（PVD）（p = 0.043）预示着总体健康得分较低。此外，术后并发症的发生是身体功能（p = 0.028）和活力（p = 0.043）降低的独立预测因素。关于移植血管数量、体外循环和主动脉阻断时间，未发现对任何SF-36分量表有显著影响（p>0.05）。
HRQoL术后下降归因于CHF和PVD等合并症、包括出血和伤口感染在内的术后并发症，以及失业和丧偶状态。因此，选择合适的手术患者并进行出院后随访可能会提高HRQoL。
