PHYSICAL AND PSYCHOSOCIAL FUNCTIONING OF WOMEN AND MEN AFTER CORONARY-ARTERY BYPASS-SURGERY
PHYSICAL AND PSYCHOSOCIAL FUNCTIONING OF WOMEN AND MEN AFTER CORONARY-ARTERY BYPASS-SURGERY
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DOI：
10.1001/jama.274.22.1767
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发表时间：
1995-12-13
影响因子：
120.7
通讯作者：
CLEARY, PD
中科院分区：
文献类型：
--
作者：
AYANIAN, JZ;GUADAGNOLI, E;CLEARY, PD
目的：评估冠状动脉搭桥手术后男女的身体和心理社会功能是否存在差异。设计-观察性队列研究。设置。-主要教学医院。患者。-从1989年6月到1990年3月连续接受冠状动脉搭桥手术的454名患者。主要观察指标。-护士评审员从医疗记录中收集关于冠状动脉疾病和并存疾病的严重程度的数据。在术后6个月存活的436名患者中，306名(70.2%)完成了一项邮寄调查，调查内容包括日常生活能力(IADL)、社会活动、心理健康和活力。每个量表的功能都根据年龄、婚姻状况、教育程度、心绞痛严重程度、近期心肌梗死、充血性心力衰竭和手术时并存的疾病进行了调整。结果：在手术前，女性比男性更有可能患有IV级心绞痛(50.9%比30.4%)，最近的心肌梗死(32.1%比18.0%)和充血性心力衰竭(34.0%比17.6%)(均为P.20)。女性在IDAL(27.2比19.6，P=0.08)、社会活动(20.8比8.0，P=.002)、精神健康(11.2比5.7，P=.05)和活力(22.2比12.9，P=0.04)方面的调整后改善与男性相似或更大。结论：在冠状动脉搭桥手术时，女性的病情比男性更严重，但女性和男性在术后6个月报告的身体和心理社会功能相似。这些发现表明，这种手术对女性和男性都有重要的功能益处。
Objective.-To assess whether physical and psychosocial functioning differs between women and men after coronary artery bypass surgery.Design.-Observational cohort study.Setting.-Major teaching hospital.Patients.-A total of 454 consecutive patients who received coronary artery bypass surgery from June 1989 through March 1990.Main Outcome Measures.-Nurse reviewers collected data on the severity of coronary artery disease and coexisting illnesses from medical records. A mailed survey measuring instrumental activities of daily living (IADLs), social activities, mental health, and vitality was completed by 306 (70.2%) of 436 patients who were alive 6 months after surgery. Functioning on each scale was adjusted for age, marital status, education, severity of angina, recent myocardial infarction, congestive heart failure, and coexisting illnesses at the time of surgery.Results.-Before surgery, women were much more likely than men to have had class IV angina (50.9% vs 30.4%), a recent myocardial infarction (32.1% vs 18.0%), and congestive heart failure (34.0% vs 17.6%) (all P.20). Women reported similar or greater adjusted improvements than men for IDALs (27.2 vs 19.6, P=.08), social activities (20.8 vs 8.0, P=.002), mental health (11.2 vs 5.7, P=.05), and vitality (22.2 vs 12.9, P=.04).Conclusions.-Women were more severely ill than men at the time of coronary artery bypass surgery, but women and men reported similar physical and psychosocial functioning 6 months after surgery. These findings demonstrate important functional benefits of this procedure among both women and men.