Pre-event quality of life and its influence on the post-event quality of life among patients with ST elevation and non-ST elevation myocardial infarctions of a premier province of Sri Lanka

Health and Quality of Life Outcomes

Research

Saroj Jayasinghe¹  M. W. Gunathunga²  R. Haniffa³  A. P. De Silva⁴  P. K. B. Mahesh⁵  S. M. Arnold⁵ 

[1] Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka;Department of Community Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka;Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand;Ministry of Health, Colombo, Sri Lanka;Office of Regional Director of Health Services, Colombo, Sri Lanka;

关键词: Quality of Life;    pre-MI QOL;    post-MI QOL;    STEMI;    NSTEMI;    Sri Lanka;    SF-36;   

DOI  :  10.1186/s12955-017-0730-9

 received in 2017-02-23, accepted in 2017-07-25,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundPre-event Quality of Life (QOL) reflects the true social circumstances in which people live prior to the onset of myocardial infarctions. It is believed to be a predictor of the post-event QOL. The aim of this study was to describe the pre-event QOL and its influence on the post-event Quality of Life among patients with ST elevation (STEMI) and Non-ST elevation myocardial infarctions (NSTEMI) using Short Form-36 (SF-36), a generic QOL tool with 8 domains. Documented literature is rare in this regard in Sri Lanka, which is a lower-middle-income country.MethodsA cross-sectional study with a 28-day post-discharge follow-up was carried out in 13 hospitals. Three hundred and forty-four patients who were diagnosed with STEMI or NSTEMI were recruited during the hospital stay. The pre-event QOL was measured using an interviewer-administered questionnaire which included the SF-36 QOL tool and medical details. Follow-up QOL was gathered using a questionnaire that was filled and posted back by participants. Of the recruited sample, 235 responded for the follow-up component. Analysis was conducted for associations between pre- and post-discharge QOL. Furthermore, comparisons were made between the STEMI and NSTEMI groups. Mann Whiney U test, Wilcoxon signed rank test and chi square test were used in the analysis.ResultsThe post-event QOL was lower in seven out of eight domains than the pre-event QOL (p < 0.05). The NSTEMI group had more risk factors and a significantly lower pre-event QOL for seven domains (p < 0.05), when compared to the STEMI group. For seven domains, the post-discharge QOL was not significantly different (p > 0.05) between the STEMI and NSTEMI groups. Post-discharge general-health QOL domain score was higher than the pre-MI score (p = 0.028) and was higher in the STEMI group compared to the NSTEMI group (p = 0.042). Regression analysis showed a significant beta coefficient between pre- and post-QOL for five domains in STEMI and for all domains in NSTEMI groups when adjusted for the disease severity. The R square values ranged from 12.3 to 62.3% for STEMI and 7.3 to 64.8% for NSTEMI.ConclusionsPre-event QOL is lower in the NSTEMI group compared to the STEMI group. Patients do not regain the previous QOL within one month post-discharge. Post-discharge QOL can be predicted by the pre-event QOL for most domains.

【 授权许可】

CC BY   
© The Author(s). 2017