Female gender is associated with impaired quality of life 1 year after coronary artery bypass surgery
Female gender is associated with impaired quality of life 1 year after coronary artery bypass surgery
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DOI：
10.1097/01.psy.0000097342.24933.a2
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发表时间：
2003-11-01
影响因子：
3.3
通讯作者：
Newman, MF
中科院分区：
文献类型：
--
作者：
Bute, BP;Mathew, J;Newman, MF
目的：在调整已知的基线差异后，评估冠状动脉搭桥手术（CABG）后一年内生活质量（QOL）和认知功能的性别相关差异。材料和方法：280 名患者（96 名女性和 184 名男性）在基线（术前）和 CABG 后一年接受了神经认知和生活质量评估。使用多变量线性回归评估性别与随访生活质量和认知功能的关系。用于评估 QOL 的指标包括 IADL、DASI、工作活动 (SF-36)、社交活动、社会支持、一般健康认知 (SF-36)、CESD、STAI 和症状限制。通过一系列基于表现的神经心理学测试来测量认知功能，通过因子分析将认知功能分数降低到四个认知领域分数，并通过自我报告测量认知困难。多元回归模型中的协变量包括年龄、受教育年限、婚姻状况、查尔森合并症指数、高血压、糖尿病、种族和基线生活质量/认知状态。结果：在一年的随访中，女性患者在生活质量的几个关键领域表现出明显较差的结果。调整基线差异后，女性认知困难 (p = 0.04) 和焦虑 (p = 0.03) 以及 DASI (p = 0.02)、IADL (p = 0.03) 和工作活动 (p = 0.02) 受损的风险更大。男性和女性因搭桥手术造成的认知后遗症相似。结论：即使在调整了影响生活质量和认知功能的已知危险因素后，女性也没有表现出与男性相同的 CABG 手术的长期质量益处。
Objective: To evaluate gender-related differences in quality of life (QOL) and cognitive function I year after coronary artery bypass surgery (CABG) after adjusting for known baseline differences. Materials and Methods: Two hundred eighty patients (96 women and 184 men) underwent neurocognitive and QOL evaluation at baseline (preoperatively) and at I year after CABG. Multivariable linear regression was used to assess the relationship of gender to follow-up QOL and cognitive function. Measures used to evaluate QOL were IADL, DASI, work activities (SF-36), social activities, social support, general health perception (SF-36), CESD, STAI, and symptom limitations. Cognitive function was measured with a battery of performance-based neuropsychological tests, reduced to a four-cognitive domain scores with factor analysis, and a self-report measure of cognitive difficulties. Covariates in multiple regression models included age, years of education, marital status, Charlson Comorbidity Index, hypertension, diabetes, race, and baseline QOL/cognitive status. Results: Female patients showed significantly worse outcome than male patients at I year follow-up in several key areas of QOL. After adjusting for baseline differences, women are at greater risk for increased cognitive difficulties (p = 0.04) and anxiety (p = 0.03), as well as impaired DASI (p = 0.02), IADL (p = 0.03), and work activities (p = 0.02). Cognitive sequelae attributable to bypass surgery were similar between men and women. Conclusions: Even after adjusting for known risk factors for compromised QOL and cognitive functioning, women do not show the same long-term quality benefits of CABG surgery that men do.