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不良社会经济因素与急性心肌梗死后一年健康相关生活质量的差距不断扩大有关。

Adverse socioeconomic factors are associated with a widening gap in one-year health-related quality of life after acute myocardial infarction.

作者信息

Füller David, Andresen-Bundus Henrike, Pagonas Nikolaos, Jaehn Philipp, Ukena Christian, Gödde Kathrin, Holmberg Christine, Ritter Oliver, Sasko Benjamin

机构信息

Brandenburg Medical School (Theodor Fontane), Neuruppin, Brandenburg an der Havel, Germany.

Division of Cardiology, Department of Internal Medicine, University Hospital Brandenburg an der Havel, Brandenburg Medical School (Theodor Fontane), Brandenburg an der Havel, Germany.

出版信息

Sci Rep. 2025 Jun 5;15(1):19791. doi: 10.1038/s41598-025-04604-1.

Abstract

Acute myocardial infarction (AMI) has a significant impact on the health-related quality of life (HRQoL) and is influenced by unfavorable socioeconomic factors. We aimed to evaluate the association between adverse socioeconomic factors including low educational level, low occupational qualification and financial hardship with presenting symptoms and HRQoL in patients hospitalized for an AMI. We hypothesized a detectable effect on a spatial level and therefore assessed the HRQoL in 298 patients with AMI using the EQ-5D-5L generic measure for health status. Sociodemographic characteristics, clinical data, medical history, and prevalence of cardiovascular risk factors were obtained. Self-reported HRQoL was determined upon hospital admission and after 12 months. Patients with lower educational attainment were more likely to report dyspnea at hospital admission, had a worse renal function and more frequently hypertension. One year post-AMI the health state of the cohort worsened in terms of the mobility, activity, pain, and anxiety/depression domains but not the self-care domain. Patients with a lower education level or a poor financial situation reported a worse HRQoL and health state at baseline and follow-up (change in EQ VAS baseline-follow-up - 7.7 and - 11.0, respectively, lowest category). In contrast, the health state of patients with a higher education level or better financial situation improved (change in EQ VAS baseline-follow-up + 4.0 and + 2.6, highest category). Our study demonstrates a substantially widening gap in the health state and HRQoL between patients with lower and higher educational attainment within the first year after AMI, already measurable on a spatial level.

摘要

急性心肌梗死(AMI)对健康相关生活质量(HRQoL)有重大影响,并受到不利社会经济因素的影响。我们旨在评估包括低教育水平、低职业资格和经济困难在内的不良社会经济因素与因AMI住院患者的症状表现和HRQoL之间的关联。我们假设在空间层面上存在可检测到的影响,因此使用EQ-5D-5L通用健康状况测量方法评估了298例AMI患者的HRQoL。获取了社会人口学特征、临床数据、病史和心血管危险因素的患病率。在入院时和12个月后确定自我报告的HRQoL。教育程度较低的患者在入院时更有可能报告呼吸困难,肾功能较差且高血压更为常见。AMI后一年,该队列在活动能力、日常活动、疼痛和焦虑/抑郁领域的健康状况恶化,但自我护理领域未恶化。教育水平较低或经济状况较差的患者在基线和随访时报告的HRQoL和健康状况较差(EQ VAS基线-随访变化分别为-7.7和-11.0,为最低类别)。相比之下,教育水平较高或经济状况较好的患者的健康状况有所改善(EQ VAS基线-随访变化分别为+4.0和+2.6,为最高类别)。我们的研究表明,在AMI后的第一年内,教育程度较低和较高的患者在健康状况和HRQoL方面的差距大幅扩大,在空间层面上已经可以测量。

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