冠状动脉搭桥术后健康相关生活质量的研究:用Duke活动指数进行性别分析

作     者：Koch C.G. Khandwala F. Cywinski J.B. 陈云茹 

作者机构：Dept. of Cardiothoracic Anesthesia The Cleveland Clinic Found ation Cleveland OH United States Dr. 

出 版 物：《世界核心医学期刊文摘（心脏病学分册）》 (Digest of the World Core Medical Journals(Cardiology))

年 卷 期：2005年第1卷第2期

页      面：58-59页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：冠状动脉搭桥术 Duke 活动指数 性别分析 生活质量 功能恢复 围手术期 术后评分 模型评估 慢性阻塞性肺病 

摘      要：Objective Our objectives were to document the preoperative and postoperative f unctional status of patients undergoing coronary artery bypass grafting, to exam ine factors that influence functional recovery, and to determine whether gender differences exist in the preoperative and postoperative functional status with t he Duke Activity Status Index. Methods One thousand eight hundred twenty five p atients undergoing isolated coronary artery bypass grafting had baseline and fol low up quality of life surveys. Mean follow up from baseline to postoperativ e Duke Activity Status Index was 8.0 months for women and men. The influence of 47 variables, in addition to baseline scores on postoperative functional status, was examined with logistic ordinal modeling. An ordinal model for the follow u p score was determined by means of backward selection, with variables retained i f they satisfied the criterion of a P value of less than .05. Results Median baseline Duke Activity Status Index scores (women, 21 .5; men, 32.2; P .001) and first follow up scores (women, 42.7; men, 58.2; P .001) were lower in women than in men. Patients who were older and those who had chronic obstructive pulmonary disease, myocardial infarction, stroke, diabetes, vascular disease, postoperative serious infection, and return to the operating room had lower postoperative scores. After adjusting for these factors, women st ill had lower follow up scores (odds ratio for men, 2.1 [95%confidence interv a l, 1.7-2.6]; P .001). Conclusions A number of preoperative factors, operative variables, and postoperative events are associated with functional recovery afte r coronary revascularization. In addition, female gender is associated with more postoperative functional impairment after adjusting for these perioperative var iables.