Ar veselību saistītās dzīves kvalitātes salīdzinājums pacientiem pirms un pēc atvērtas sirds operācijas
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Date
2020
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Ievads: Kadiovaskulārās slimības ieņem aizvien lielāku lomu kopējo slimību vidū un bieži vien tās tiek koriģētas ķirurģiskā ceļā. Latvijā katru gadu veic ap 1100 sirds operācijas. Tieši pēdējo gadu laikā arvien vairāk tiek pievērsta uzmanība dzīves kvalitātei, kuras paaugstināšanās liecina par pozitīvu ārstēšanas iznākumu. Visbiežāk ar veselību saistītās dzīves kvalitātes noteikšanai izmanto SF-36 anketu, kurā no 8 apakškategorijām iegūst 2 dzīves kvalitātes komponentes: fizisko un mentālo veselību. Augstāki rādītāji visās kategorijās raksturo labāku dzīves kvalitāti.
Hipotēze: Pacientiem 1 mēnesi pēc atvērtas sirds operācijas HRQOL novērtējums ir augstāks nekā pirms operācijas.
Mērķis: Salīdzināt HRQOL pacientiem pirms un 1 mēnesi pēc atvērtas sirds operācijas.
Metodes: Veikts prospektīvs pētījums Paula Stradiņa klīniskās universitātes slimnīcā Sirds ķirurģijas centrā laika posmā no 1.05.2019. līdz 1.01.2020. Pētījumā iekļauti pacienti, kuriem veikta atvērta sirds operācija, kuri ir korekti aizpildījuši HRQOL anketu SF-36 pirms un 1 mēnesi pēc operācijas un kam ir pilnvērtīgi aizpildīta medicīniskā dokumentācija.
Rezultāti: Kopumā pētījumā tika analizēti 22 pacienti, no tiem 81,8% (n=18) bija vīrieši. Pacientu vidējais vecums bija 63,31 (±3.0)gadi. Pacientu mediānais dienu skaits stacionārā bija 16 dienas un IT 3 dienas. Vidējais mortalitātes risks pēc EuroSCORE bija 3,53 (±0,62). HRQOL pirms operācijas bija 64,91%, bet 1 mēnesi pēc bija 58,54%. Tika noteikta statistiski ticama korelācija starp pēc operācijas uzrādīto HRQOL ar stacionārā pavadīto dienu skaitu [Spearman’s r=-0,643; p<0,001] un ar IT pavadīto dienu skaitu [ r=-0,728; p<0,001]. Starp šiem rādītājiem un pirms operācijas HRQOL statistiski ticamas korelācijas nav.
Secinājumi: 1 mēnesi pēc atvērtas sirds operācijas pacientu fiziskie un mentālie HRQOL rādītāji bija pasliktinājušies. Apskatot literatūru, tiek secināts, ka 6 nedēļas pēc operācijas pacienti var veikt ikdienas aktivitātes, pēc 3 mēnešiem smagas fiziskas aktivitātes. Tas liek secināt, ka pacienti nav pilnvērtīgi atgriezušiem iepriekšējā ikdienas ritmā, kā pirms operācijas. Tāpat HRQOL rādītājus pēc operācijas ietekmē arī stacionārā un IT pavadīto dienu skaits.
Introduction: Cardiovascular diseases are becoming more common than ever and often they are being threated surgically. Latvia performs approximately 1100 heart surgeries annualy. Lately during recent years a significant attention is being paid to patient’s quality of life. Elevation of these aspects indicates positive treatment results. SF=36 questionnaire is the most common tool used to evaluate the HRQOL. It consists of 8 categories and obtains quality of life components: physical and mental health. Higher results in all categories evidence better quality of life. Hypothesis: HRQOL for patients 1 month after open heart surgery is higher than before surgery. Aim: To compare HRQOL assessment for patients before and 1 month after open heart surgery. Methodes: A prospective study was held in Latvian Center of Cardiology in Pauls Stradiņš Clinical University Hospital from 01.05.2019. until 01.01.2020. Participants included in the study were patients who underwent open heart surgery and filled in the HRQOL questionnaire SF-36 properly before and 1 month after the surgery, and whose medical documentation was properly filled in. Results: In total 22 patients were included in the study, 81.8% (n=18) of them were men. Patient’s mean age was 63.31 (± 3.0) years. Patient’s median number of days in the hospital was 16 days and in the intensive care unit 3 days. Mean mortality risk according to EuroSCORE was calculated as 3.53 (± 0.62). Patient’s health-related quality of life before open heart surgery was 64.91% but one month after the surgery it decreased to 58.54%. Statistically significant correlation was established between assessed health-related quality of life (HRQOL) and the number of days spent in the hospital after the surgery [Spearman’s r=-0.643; p<0.001] and between the number of days spent in intensive care unit [r=-0.728; p<0.001]. No statistically significant correlation was found between these parameters and HRQOL before the surgery. Conclusions: One month after surgery patient’s physical and mental HRQOL parameters were decreased. According to the literature patients 6 weeks after surgery can perform mild physical activities, after 3months- severe activities. It leads to the conclusion that patients have not yet fully recovered into their normal daily rhythm as they were before the surgery. HRQOL parameters are affected by the number of days spent in the hospital and intensive care unit.
Introduction: Cardiovascular diseases are becoming more common than ever and often they are being threated surgically. Latvia performs approximately 1100 heart surgeries annualy. Lately during recent years a significant attention is being paid to patient’s quality of life. Elevation of these aspects indicates positive treatment results. SF=36 questionnaire is the most common tool used to evaluate the HRQOL. It consists of 8 categories and obtains quality of life components: physical and mental health. Higher results in all categories evidence better quality of life. Hypothesis: HRQOL for patients 1 month after open heart surgery is higher than before surgery. Aim: To compare HRQOL assessment for patients before and 1 month after open heart surgery. Methodes: A prospective study was held in Latvian Center of Cardiology in Pauls Stradiņš Clinical University Hospital from 01.05.2019. until 01.01.2020. Participants included in the study were patients who underwent open heart surgery and filled in the HRQOL questionnaire SF-36 properly before and 1 month after the surgery, and whose medical documentation was properly filled in. Results: In total 22 patients were included in the study, 81.8% (n=18) of them were men. Patient’s mean age was 63.31 (± 3.0) years. Patient’s median number of days in the hospital was 16 days and in the intensive care unit 3 days. Mean mortality risk according to EuroSCORE was calculated as 3.53 (± 0.62). Patient’s health-related quality of life before open heart surgery was 64.91% but one month after the surgery it decreased to 58.54%. Statistically significant correlation was established between assessed health-related quality of life (HRQOL) and the number of days spent in the hospital after the surgery [Spearman’s r=-0.643; p<0.001] and between the number of days spent in intensive care unit [r=-0.728; p<0.001]. No statistically significant correlation was found between these parameters and HRQOL before the surgery. Conclusions: One month after surgery patient’s physical and mental HRQOL parameters were decreased. According to the literature patients 6 weeks after surgery can perform mild physical activities, after 3months- severe activities. It leads to the conclusion that patients have not yet fully recovered into their normal daily rhythm as they were before the surgery. HRQOL parameters are affected by the number of days spent in the hospital and intensive care unit.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
Ar veselību saistītā dzīves kvalitāte; SF-36 aptauja; sirds operācija, health related quality of life; SF-36 questionnaire; heart surgery