The association between self-rated health and mortality in a well-characterized sample of coronary artery disease patients
The association between self-rated health and mortality in a well-characterized sample of coronary artery disease patients
复制标题
DOI：
10.1097/00005650-199912000-00006
复制
发表时间：
1999-12-01
期刊：
影响因子：
3
通讯作者：
Mark, DB
中科院分区：
文献类型：
--
作者：
Bosworth, HB;Siegler, IC;Mark, DB
背景。在调整社会人口变量、医生评定的合并症、疾病严重程度、健康相关生活质量（HRQOL）和社会心理测量（抑郁、社会支持和功能能力）后，自评健康与死亡率之间的关系在社会支持中介（MOSS）研究中进行了检验。样本包括2,885人（平均年龄62.5岁），他们在心导管检查中有明显的心脏病。使用Cox比例生存分析，在随访期间（平均3.5年），将健康状况评价为“一般”或“较差”的个体的全因死亡率（or = 2.13; CI = 1.40-3.25; or = 4.92; CI = 3.24-7.46）显著高于考虑社会人口因素后将健康状况评价为“非常好”的个体。在对合并症、疾病严重程度、NRQOL、心理社会因素和人口统计学变量进行调整后，只有那些认为自己健康状况较差的人有显著更高的死亡风险（OR = 2.96, CI = 1.80-4.85）。冠状动脉疾病（CAD）相关死亡率也观察到类似的模式；变量调整的增加削弱了自评健康与死亡率之间的关系。在对所有可用的死亡率风险因素进行调整后，健康状况为差的个体比健康状况为很好的个体（差对很好的OR = 3.58, CI = 2.13-6.02）的cad相关死亡率风险显著高于健康状况为很好的个体。这项研究表明，在研究死亡的危险因素时，包括自我评估的健康状况是很重要的。在CAD患者样本中，不调整相关因素可能会高估自评健康对死亡率的影响。
BACKGROUND. The relationship between self-rated health and mortality after adjustment for sociodemographic variables, physician-rated comorbidities, disease severity, health-related quality of life (HRQOL), and psychosocial measures (depression, social support, and functional ability) was examined in the Mediators of Social Support: (MOSS) study.SUBJECTS. The sample consisted of 2,885 individuals (mean age, 62.5 years) who had significant heart disease based upon heart catheterization.RESULTS. Using Cox proportional survival analysis, individuals who rated their health as "fair" or "poor" had a significantly greater likelihood of all-cause mortality (OR = 2.13; CI = 1.40-3.25; OR = 4.92; CI = 3.24-7.46, respectively) across follow-up (mean, 3.5 years) than those who rated their health as "very good" after considering sociodemographic factors. After adjustment for comorbidities, disease severity, NRQOL, psychosocial factors, and demographic variables, only those who rated their health as poor had a significant greater risk of mortality (OR = 2.96, CI = 1.80-4.85). A similar pattern was observed for coronary artery disease (CAD)-related mortality; increased adjustment of variables weakened the relationship between self-rated health and mortality. Individuals who rated their health as poor had a significantly greater risk of CAD-related mortality than did those who rated their health as very good (poor vs. very good OR = 3.58, CI = 2.13-6.02) after adjustment for all available mortality risk factors.CONCLUSIONS. This study indicates that it is important to include self-rated health when studying risk factors for mortality. Not adjusting for relevant factors may provide an overestimation of the effects of self-rated health on mortality in a sample of CAD patients.