Item nonresponse to psychosocial questionnaires was associated with higher mortality after acute myocardial infarction
Item nonresponse to psychosocial questionnaires was associated with higher mortality after acute myocardial infarction
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DOI：
10.1016/j.jclinepi.2010.03.010
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发表时间：
2011-02-01
影响因子：
7.2
通讯作者：
Alter, David A.
中科院分区：
文献类型：
--
作者：
Candido, Elisa;Kurdyak, Paul;Alter, David A.
目的：探讨对心理社会问卷选择性不答复与急性心肌梗死 (AMI) 后死亡率之间的关系。 研究设计和背景：招募 2690 名 AMI 住院后的 AMI 幸存者来完成为期 30 天的随访访谈。根据患者对医疗结果研究 (MOS) 社会支持调查 (MOS-SSS) 的反应程度，将患者分为四组（未参与调查、完全无反应、部分无反应和无项目无反应）。根据基线社会人口统计学、临床和社会心理（即社会隔离）特征进行调整的 Cox 比例风险模型用于检查 AMI 后 3 年各反应水平的全因死亡率。结果：13.9% 的合格患者拒绝随访参与；高达 14.7% 的参与者存在 MOS-SSS 项目无反应，并且在老年人、社会弱势群体和临床风险较高的人群中更为常见。存在无反应死亡率梯度，范围从 8.9%（无项目无反应）到 18.7%（完全项目无反应）（P < 0.001）。调整基线特征后，完整的项目无反应仍然与死亡率显着相关（风险比：1.33；95% 置信区间：1.02-1.73）。结论：对社会支持调查问卷的项目无反应与 AMI 后较高的死亡率相关。尽管解释因素可能包括年龄和基线临床风险，但其他心理社会和/或未测量因素可能会导致较差的预后。 (C) 2011 Elsevier Inc. 保留所有权利。
Objective: To examine the relationship between selective nonresponse to a psychosocial questionnaire and mortality after acute myocardial infarction (AMI).Study Design and Setting: Two thousand six hundred and ninety AMI survivors after AMI hospitalization were recruited to complete a 30-day follow-up interview. Patients were classified into four groups (survey nonparticipation and complete, partial, and no item nonresponse) according to their degree of response to the Medical Outcomes Study (MOS) Social Support Survey (MOS-SSS). Cox proportional hazard models, adjusted for baseline sociodemographic, clinical, and psychosocial (i.e., social isolation) characteristics, were used to examine all-cause mortality, 3 years post-AMI, across the response levels.Results: 13.9% of the eligible patients refused follow-up participation; MOS-SSS item nonresponse was present in up to 14.7% of participants and was more frequent among the elderly, socially disadvantaged, and those with higher clinical risk. A nonresponse mortality gradient existed, ranging from 8.9% (no item nonresponse) to 18.7% (complete item nonresponse) (P < 0.001). After adjusting for baseline characteristics, complete item nonresponse remained significantly associated with mortality (hazard ratio: 1.33; 95% confidence interval: 1.02-1.73).Conclusions: Item nonresponse to a social support questionnaire is associated with higher mortality post-AMI. Although explanatory factors may include age and baseline clinical risk, additional psychosocial and/or unmeasured factors may account for the poorer prognosis. (C) 2011 Elsevier Inc. All rights reserved.