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择期经皮冠状动脉血运重建术后的健康变化。通用测量方法与特定测量方法的比较。

Changes in health after elective percutaneous coronary revascularization. A comparison of generic and specific measures.

作者信息

Krumholz H M, McHorney C A, Clark L, Levesque M, Baim D S, Goldman L

机构信息

Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT 06520-8017, USA.

出版信息

Med Care. 1996 Aug;34(8):754-9. doi: 10.1097/00005650-199608000-00003.

Abstract

OBJECTIVES

This study determines changes in health-related quality of life after elective percutaneous transluminal coronary angioplasty and compares generic and specific measures.

METHODS

Changes in health-related quality of life were measured in consecutive, symptomatic patients undergoing elective percutaneous coronary revascularization using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), the Specific Activity Scale (SAS), and the Canadian Cardiovascular Society Classification (CCSC). The patients were interviewed as outpatients before admission and at least 6 months later.

RESULTS

There were significant changes in the following SF-36 measures: physical functioning (postscore minus prescore = 19.1 +/- 24.1), role limitations due to physical-health problems (40.4 +/- 47.2), bodily pain (19.9 +/- 29.3), vitality (12.9 +/- 25.1), social functioning (20.0 +/- 33.1), role limitations due to emotional-health problems (26.7 +/- 49.0), and general mental health (7.1 +/- 21.2). General health perceptions did not change significantly. Internal-consistency reliability coefficients for these measures ranged from 0.73 to 0.91. There also was significant improvement in the CCSC class, but the SAS class did not change significantly. Overall, the SF-36 role-physical scale was the most responsive to changes after elective percutaneous coronary revascularization, followed by the CCSC and the SF-36 physical functioning scale.

CONCLUSIONS

Although this study cannot determine the causal role of elective percutaneous coronary revascularization in these changes, it provides support for the usefulness of these measures in future evaluations of this intervention.

摘要

目的

本研究确定择期经皮腔内冠状动脉成形术后健康相关生活质量的变化,并比较通用测量方法和特定测量方法。

方法

使用医学结局研究简明健康调查36项量表(SF - 36)、特定活动量表(SAS)和加拿大心血管学会分级(CCSC),对连续的有症状且接受择期经皮冠状动脉血运重建的患者进行健康相关生活质量变化的测量。在患者入院前作为门诊病人进行访谈,并在至少6个月后再次访谈。

结果

SF - 36量表的以下各项测量有显著变化:生理功能(术后得分减去术前得分 = 19.1±24.1)、因身体健康问题导致的角色受限(40.4±47.2)、身体疼痛(19.9±29.3)、活力(12.9±25.1)、社会功能(20.0±33.1)、因情绪健康问题导致的角色受限(26.7±49.0)和总体心理健康(7.1±21.2)。总体健康感知无显著变化。这些测量的内部一致性信度系数范围为0.73至0.91。CCSC分级也有显著改善,但SAS分级无显著变化。总体而言,SF - 36角色 - 生理量表对择期经皮冠状动脉血运重建术后的变化反应最敏感,其次是CCSC和SF - 36生理功能量表。

结论

尽管本研究无法确定择期经皮冠状动脉血运重建在这些变化中的因果作用,但它为这些测量方法在该干预措施未来评估中的有用性提供了支持。

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