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巴基斯坦人群心肌梗死后的生活质量——来自单中心队列研究的见解

Quality of life after myocardial infarction in the pakistani population - insights from a single-center cohort study.

作者信息

Hassan Javerya, Abbas Manzar, Arshad Hajra, Jessani Angelina, Tahir Izza, Qazi Shiza, Shah Jasmit, Merali Zul, Samad Zainab

机构信息

Department of Medicine, Aga Khan University Hospital, Karachi, 74800, Pakistan.

Medical College, Aga Khan University, Karachi, Pakistan.

出版信息

BMC Cardiovasc Disord. 2024 Dec 23;24(1):741. doi: 10.1186/s12872-024-04283-2.

Abstract

BACKGROUND

Health-related Quality of life (HRQoL) assessment is essential for optimizing patient care, treatment adjustments, and medical decision-making, particularly in post-Myocardial Infarction (MI) patients, but limited data exists on HRQOL post-MI from Pakistan. This study aimed to assess HRQoL and its determinants in the Pakistani population.

METHODS

A single-center cross-sectional study was conducted at a tertiary care hospital in Karachi, Pakistan. Patients ≥ 18 years old with a primary diagnosis of acute MI (ICD-9 codes: 410.0-410.9 and ICD-10 codes: 121.0-121.9) discharged from the Cardiology Service from January 2019 to December 2020 who could be contacted and consented to participate were included. Data was collected from electronic records, and patients were interviewed via phone calls using a validated Urdu version of the WHOQOL-BREF questionnaire. Statistical analysis was performed using non-parametric tests via RStudio (Version 1.4.1717).

RESULTS

The final study cohort was 440 patients with a median age of 63.0 (IQR: 56.0,72.0) years, with a male predominance (68.2%). Physical health was the most affected domain. Females, lower-income individuals, and those with lower levels of education had lower HRQoL scores in all domains. Diabetes and the presence of multiple co-morbidities were associated with lower HRQoL. Marital and socioeconomic status, along with psychosocial factors were significantly associated with HRQoL scores. Notably, 62.0% of post-MI patients rated their overall HRQoL as good (4-5 on a Likert scale of 1-5). Cronbach's alpha values indicated good internal consistency, with an overall Cronbach's alpha of 0.902.

CONCLUSION

Although a significant proportion of patients in our cohort reported good HRQoL post-MI, several social factors were associated with lower HRQoL. These factors must be investigated further in discharge planning and post-discharge of patients with MI.

摘要

背景

健康相关生活质量(HRQoL)评估对于优化患者护理、治疗调整和医疗决策至关重要,尤其是在心肌梗死(MI)后患者中,但来自巴基斯坦的心肌梗死后HRQoL数据有限。本研究旨在评估巴基斯坦人群的HRQoL及其决定因素。

方法

在巴基斯坦卡拉奇的一家三级护理医院进行了一项单中心横断面研究。纳入2019年1月至2020年12月从心脏病科出院、年龄≥18岁、初步诊断为急性心肌梗死(ICD-9编码:410.0-410.9和ICD-10编码:121.0-121.9)且能够取得联系并同意参与的患者。数据从电子记录中收集,通过电话使用经过验证的乌尔都语版WHOQOL-BREF问卷对患者进行访谈。使用RStudio(版本1.4.1717)通过非参数检验进行统计分析。

结果

最终研究队列包括440名患者,中位年龄为63.0(四分位间距:56.0,72.0)岁,男性占主导(68.2%)。身体健康是受影响最严重的领域。女性、低收入个体和教育程度较低的个体在所有领域的HRQoL得分较低。糖尿病和多种合并症的存在与较低的HRQoL相关。婚姻和社会经济状况以及心理社会因素与HRQoL得分显著相关。值得注意的是,62.0%的心肌梗死后患者将其总体HRQoL评为良好(在1-5李克特量表上为4-5)。克朗巴哈系数值表明内部一致性良好,总体克朗巴哈系数为0.902。

结论

尽管我们队列中的很大一部分患者报告心肌梗死后HRQoL良好,但一些社会因素与较低的HRQoL相关。在心肌梗死患者的出院计划和出院后必须进一步调查这些因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4144/11664848/cd642f5c9c95/12872_2024_4283_Fig1_HTML.jpg

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