Matsuda Kohei, Fujisawa Daisuke, Masai Kyohei, Miyazaki Naoki, Suzuki Shigeki, Okubo Yu, Kaseda Kaoru, Asakura Keisuke, Hishida Tomoyuki, Asamura Hisao
Division of Thoracic Surgery, Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
Department of General Thoracic Surgery, Sagamihara Kyodo Hospital, Kanagawa, Japan.
JTCVS Open. 2024 Apr 2;19:355-369. doi: 10.1016/j.xjon.2024.03.013. eCollection 2024 Jun.
The quality of life (QOL) and psychological states of patients with pectus excavatum (PE) have yet to be well understood. This study aimed to evaluate the health-related QOL (HRQOL), psychological states, and personality traits of patients with PE, alongside the associations of these factors with the severity of PE.
A cross-sectional evaluation was prospectively performed in patients scheduled to undergo PE repair surgery between July 2019 and April 2021. The primary outcome was the patients' HRQOL, and the secondary outcomes were depression, social anxiety, self-efficacy, and personality traits.
In total, 129 patients were subjected to analyses. Patients' HRQOL had a lower role component summary score (mean ± standard deviation: 41.8 ± 12.8, < .001) than the general population controls. Patients' HRQOL had a significantly better physical component summary (54.0 ± 10.4, < .001) and mental component summary (53.3 ± 8.8, < .001) than that of the general population. Fourteen patients' (10.9%) and 56 patients' (43.4%) scores indicated the presence of depression and social anxiety disorder, respectively. Patients' self-efficacy (46.1 ± 11.4, , .001) and level of extraversion (46.5 ± 11.8, < .001) were lower than those of the general population. No significant correlation was found between the severity of PE and these scores.
Our study revealed that patients with PE had decreased social-role QOL, depressive tendencies, increased social anxiety, lower self-efficacy, and introversion. No correlation between the severity of PE and the patients' psychological outcomes leads us to conclude that surgical implications of PE should not be decided solely by a physical index.
漏斗胸(PE)患者的生活质量(QOL)和心理状态尚未得到充分了解。本研究旨在评估PE患者的健康相关生活质量(HRQOL)、心理状态和人格特质,以及这些因素与PE严重程度的关联。
对2019年7月至2021年4月期间计划接受PE修复手术的患者进行前瞻性横断面评估。主要结局是患者的HRQOL,次要结局是抑郁、社交焦虑、自我效能感和人格特质。
共有129例患者接受分析。患者的HRQOL角色成分总结得分(均值±标准差:41.8±12.8,<0.001)低于一般人群对照组。患者的HRQOL身体成分总结得分(54.0±10.4,<0.001)和精神成分总结得分(53.3±8.8,<0.001)显著优于一般人群。分别有14例患者(10.9%)和56例患者(43.4%)的得分表明存在抑郁和社交焦虑障碍。患者的自我效能感(46.1±11.4,<0.001)和外向性水平(46.5±11.8,<0.001)低于一般人群。未发现PE严重程度与这些得分之间存在显著相关性。
我们的研究表明,PE患者的社会角色QOL降低、有抑郁倾向、社交焦虑增加、自我效能感较低且性格内向。PE严重程度与患者心理结局之间无相关性,这使我们得出结论,PE的手术指征不应仅由身体指标决定。