Health status predicts long-term outcome in outpatients with coronary disease
Health status predicts long-term outcome in outpatients with coronary disease
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DOI：
10.1161/01.cir.0000020688.24874.90
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发表时间：
2002-07-02
期刊：
影响因子：
37.8
通讯作者：
Fihn, SD
中科院分区：
文献类型：
--
作者：
Spertus, JA;Jones, P;Fihn, SD
背景：虽然患者报告的健康状况测量已被用作临床试验的终点，但在其他情况下很少使用。证明它们能独立预测冠心病门诊患者的死亡率和住院率，可以强调它们的临床价值。方法和结果：本研究评估了西雅图心绞痛问卷（SAQ）的预后效用，SAQ是冠状动脉疾病患者的疾病特异性健康状况测量。患者被纳入了一项来自6家退伍军人事务综合内科诊所的前瞻性队列研究。所有完成SAQ并随访1年的冠状动脉疾病患者进行分析（n=5558）。SAQ预测变量为身体限制、心绞痛稳定性、心绞痛频率和生活质量评分。主要结局是1年全因死亡率，次要结局是急性冠脉综合征（ACS）住院。较低的SAQ评分与死亡率和ACS入院风险增加有关。控制人口统计学和临床特征的预后模型显示出显著的独立死亡风险，SAQ身体限制得分较低，轻度的优势比较低。中度和重度的限制分别为1.5、2.0和4.0，而最低限制(P
Background-Although patient-reported health status measures have been used as end points in clinical trials, they are rarely used in other settings. Demonstrating that they independently predict mortality and hospitalizations among Outpatients with coronary disease could emphasize their clinical value.Methods and Results-This stud evaluated the prognostic utility of the Seattle Angina Questionnaire (SAQ), a disease- specific health status measure for patients with coronary artery disease. Patients were enrolled in a prospective cohort study from 6 Veterans Affairs General Internal Medicine Clinics. All patients reporting coronary artery disease who completed a SAQ and had I year of follow-up were analyzed (n=5558). SAQ predictor variables were the physical limitation, angina stability, angina frequency, and quality-of-life scores. The primary outcome was 1-year all-cause mortality, and a secondary outcome was hospitalization for acute coronary syndrome (ACS). Lower SAQ scores were associated with increased risks of mortality and ACS admissions. Prognostic models controlling for demographic and clinical characteristics demonstrated significant independent mortality risk with lower SAQ physical limitation scores-, odds ratios for mild. moderate, and severe limitation were 1.5, 2.0, and 4.0 versus minimal limitation (P