Swipe om te navigeren naar een ander artikel
The study was conducted at the Departments of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway
To explore associations between HRQL, marital status, and comorbid disorders in men and women following cardiac surgery.
A secondary analysis was completed using data from a randomized controlled trial in which 416 individuals (23% women) scheduled for elective coronary artery bypass graft and/or valve surgery were recruited between March 2012 and September 2013. HRQL was assessed using the Health State Descriptive System (15D) preoperatively, then at 2 weeks, and at 3, 6, and 12 months following cardiac surgery. Linear mixed model analyses were performed to explore associations between HRQL, social support, and comorbid disorders.
The overall 15D scores for the total sample improved significantly from 2 weeks to 3 months post surgery, with only a gradual change observed from 3 to 12 months. Thirty percent (n = 92) of the total sample reported a lower 15D total score at 12 months compared to preoperative status, of whom 78% (n = 71) had a negative minimum important differences (MID), indicating a worse HRQL status. When adjusted for age and marital status, women had statistically significant lower 15D total scores compared to men at 3, 6, and 12 months post surgery. Compared to pre-surgery, improvement was demonstrated in 4 out of 15 dimensions of HRQL for women, and in 6 out of 15 dimensions for men at 12 months post surgery. Both men and women associated back/neck problems, depression, and persistent pain intensity with lower HRQL; for women, not living with a partner/spouse was associated with lower HRQL up to 12 months.
Women experienced decreased HRQL and a slower first-year recovery following cardiac surgery compared to men. This study demonstrates a need for follow-up and support to help women manage their symptoms and improve their function within the first year after cardiac surgery. This was particularly pronounced for those women living alone.
Log in om toegang te krijgen
Met onderstaand(e) abonnement(en) heeft u direct toegang:
Mohr, F. W., Morice, M. C., Kappetein, A. P., Feldman, T. E., Ståhle, E., Colombo, A., et al. (2013). Coronary artery bypass graft surgery versus percutaneous coronary intervention in patients with three-vessel disease and left main coronary disease: 5-year follow-up of the randomised, clinical SYNTAX trial. The Lancet, 381(9867), 629–638. CrossRef
Gaspar, M., & Călinescu, F. B. (2016). Long-term clinical outcome following CABG. Coronary graft failure (pp. 199–215). Cham: Springer. CrossRef
Kloth, B., Schietsch, O., Sill, B., Schönebeck, J., Reichenspurner, H., & Gulbins, H. (2016). Does cardiac surgery affect quality of life? An update of more than 200 patients. The Thoracic and Cardiovascular Surgeon, 64(S01), ePP21.
De Smedt, D., Clays, E., & De Bacquer, D. (2016). Measuring health-related quality of life in cardiac patients. European Heart Journal-Quality of Care and Clinical Outcomes. doi: 10.1093/ehjqcco/qcw015.
Middel, B., El Baz, N., Pedersen, S. S., Van Dijk, J. P., Wynia, K., & Reijneveld, S. A. (2014). Decline in health-related quality of life 6 months after coronary artery bypass graft surgery: The influence of anxiety, depression, and personality traits. Journal of Cardiovascular Nursing, 29(6), 544–554. CrossRefPubMed
Oterhals, K., Hanssen, T. A., Haaverstad, R., Nordrehaug, J. E., Eide, G. E., & Norekval, T. M. (2015). Factors associated with poor self-reported health status after aortic valve replacement with or without concomitant bypass surgery. European Journal of Cardio-Thoracic Surgery, 48(2), 283–292. CrossRefPubMed
Martin, L. M., Holmes, S. D., Henry, L. L., Schlauch, K. A., Stone, L. E., Roots, A., et al. (2012). Health-related quality of life after coronary artery bypass grafting surgery and the role of gender. Cardiovascular Revascularization Medicine: Including Molecular Interventions, 13(6), 321–327. CrossRef
McSweeney, J. C., Rosenfeld, A. G., Abel, W. M., Braun, L. T., Burke, L. E., Daugherty, S. L., et al. (2016). Preventing and experiencing ischemic heart disease as a woman: State of the science a scientific statement from the American Heart Association. Circulation, 133(13), 1302–1331. CrossRefPubMedPubMedCentral
Beckie, T. M. (2014). Biopsychosocial determinants of health and quality of life among young women with coronary heart disease. Current Cardiovascular Risk Reports, 8(1), 1–10. CrossRef
Noyez, L. (2014). Is quality of life post cardiac surgery overestimated? Health and Quality of Life Outcomes, 12(1), 1. CrossRef
De Smedt, D., Clays, E., Höfer, S., Oldridge, N., Kotseva, K., Maggioni, A. P., et al. (2016). The use of HeartQoL in patients with coronary heart disease: Association with risk factors and European reference values. The EUROASPIRE IV study of the European Society of Cardiology. European Journal of Preventive Cardiology. doi: 10.1177/2047487316631400.
Heiskanen, J., Tolppanen, A.-M., Roine, R. P., Hartikainen, J., Hippeläinen, M., Miettinen, H., et al. (2016). Comparison of EQ-5D and 15D instruments for assessing the health-related quality of life in cardiac surgery patients. European Heart Journal-Quality of Care and Clinical Outcomes. doi: 10.1093/ehjqcco/qcw002.
Vainiola, T., Roine, R. P., Suojaranta-Ylinen, R., Vento, A., & Sintonen, H. (2013). Can factors related to mortality be used to predict the follow-up health-related quality of life (HRQoL) in cardiac surgery patients? Intensive & Critical Care Nursing, 29(6), 337–343. CrossRef
Stenvall, H., Tierala, I., Räsänen, P., Laine, M., Sintonen, H., & Roine, R. P. (2017). Long-term clinical outcomes, health-related quality of life and costs in different treatment modalities of stable coronary artery disease. European Heart Journal-Quality of Care and Clinical Outcomes, 3(1), 74–82. doi: 10.1093/ehjqcco/qcw024. CrossRef
Bjornnes, A. K., Parry, M., Lie, I., Fagerland, M. W., Watt-Watson, J., Rustoen, T., et al. (2017). The impact of an educational pain management booklet intervention on postoperative pain control after cardiac surgery. European Journal of Cardiovascular Nursing, 16(1), 18–27. doi: 10.1177/1474515116631680. CrossRefPubMed
De-loyde, K. J., Harrison, J. D., Durcinoska, I., Shepherd, H. L., Solomon, M. J., & Young, J. M. (2015). Which information source is best? Concordance between patient report, clinician report and medical records of patient co-morbidity and adjuvant therapy health information. Journal of Evaluation in Clinical Practice, 21(2), 339–346. CrossRefPubMed
Cleeland, C. S., & Ryan, K. M. (1994). Pain assessment: Global use of the brief pain inventory. Annals of the Academy of Medicine, Singapore, 23(2), 129–138. PubMed
Stata, S. (2013). Release 13. Statistical software. College Station, Texas: StataCorp LP.
Fitzmaurice, G. M., Laird, N. M., & Ware, J. H. (2011). Applied longitudinal analysis (2nd ed.). Chichester: Wiley.
Choiniere, M., Watt-Watson, J., Victor, J. C., Baskett, R. J., Bussieres, J. S., Carrier, M., et al. (2014). Prevalence of and risk factors for persistent postoperative nonanginal pain after cardiac surgery: A 2-year prospective multicentre study. CMAJ: Canadian Medical Association Journal, 186(7), E213–E223. CrossRefPubMedPubMedCentral
Rantanen, A., Kaunonen, M., Tarkka, M., Sintonen, H., Koivisto, A.-M., Astedt-Kurki, P., et al. (2009). Patients’ and significant others’ health-related quality of life one month after coronary artery bypass grafting predicts later health-related quality of life. Heart and Lung, 38(4), 318–329. CrossRefPubMed
Hu, Y., van Lenthe, F. J., Borsboom, G. J., Looman, C. W. N., Bopp, M., Burström, B., et al. (2016). Trends in socioeconomic inequalities in self-assessed health in 17 European countries between 1990 and 2010. Journal of Epidemiology and Community Health. doi: 10.1136/jech-2015-206780. PubMedCentral
Hansen, T. B., Thygesen, L. C., Zwisler, A. D., Helmark, L., Hoogwegt, M., Versteeg, H., et al. (2015). Self-reported health-related quality of life predicts 5-year mortality and hospital readmissions in patients with ischaemic heart disease. European Journal of Preventive Cardiology, 22(7), 882–889. CrossRefPubMed
Banack, H. R., Holly, C. D., Lowensteyn, I., Masse, L., Marchand, S., Grover, S. A., et al. (2014). The association between sleep disturbance, depressive symptoms, and health-related quality of life among cardiac rehabilitation participants. Journal of Cardiopulmonary Rehabilitation and Prevention, 34(3), 188–194. CrossRefPubMed
Katz, J., Weinrib, A., Fashler, S., Katznelzon, R., Shah, B., Ladak, S., et al. (2015). The Toronto General Hospital Transitional Pain Service: Development and implementation of a multidisciplinary program to prevent chronic postsurgical pain. Journal of Pain Research, 8, 695–702. doi: 10.2147/JPR.S91924. CrossRefPubMedPubMedCentral
Bartley, E. J., & Fillingim, R. B. (2013). Sex differences in pain: A brief review of clinical and experimental findings. Brithish Journal of Anaesthesia, 111(1), 52–58. CrossRef
Zebhauser, A., Baumert, J., Emeny, R., Ronel, J., Peters, A., & Ladwig, K. (2015). What prevents old people living alone from feeling lonely? Findings from the KORA-Age-study. Aging & Mental Health, 19(9), 773–780. CrossRef
Dear, B. F., Gandy, M., Karin, E., Staples, L. G., Johnston, L., Fogliati, V. J., et al. (2015). The pain course: A randomised controlled trial examining an internet-delivered pain management program when provided with different levels of clinician support. Pain, 156(10), 1920–1935. CrossRefPubMedPubMedCentral
Licskai, C., Sands, T., & Ferrone, M. (2013). Development and pilot testing of a mobile health solution for asthma self-management: Asthma action plan smartphone application pilot study. Canadian Respirology Journal, 20(4), 301–306. CrossRef
De Smedt, D., Clays, E., Annemans, L., Doyle, F., Kotseva, K., Pająk, A., et al. (2013). Health related quality of life in coronary patients and its association with their cardiovascular risk profile: Results from the EUROASPIRE III survey. International Journal of Cardiology, 168(2), 898–903. CrossRefPubMed
Yang, K., & Victor, C. (2011). Age and loneliness in 25 European nations. Ageing & Society, 31(08), 1368–1388. CrossRef
- Impact of marital status and comorbid disorders on health-related quality of life after cardiac surgery
Ann Kristin Bjørnnes
- Springer International Publishing