The Association Between Health Related Quality of Life and Five Year Mortality in Patients with ST-Elevated Myocardial Infarction

Abstract

Introduction: There is a lack of studies focusing on the association between health related quality of life (HRQoL) and mortality. In our study, we aimed to evaluate the association between HRQoL and mortality of patients with ST-elevated myocardial infarction (STEMI) treated by percutaneous coronary intervention (PCI).

Patients and Methods: Ninety-two patients with STEMI undergoing primary PCI with committed 6-month follow-up were included to the study. In the 6-month follow-up visit, EQ5D questionnaire, which is valid internationally and is also valid for studies performed in Turkey for acute coronary syndromes, was filled by patients after obtaining their demographical and clinical findings. Data analyzes were performed after 5-year follow-up. Mortality of the patients whose clinical visits could not be performed evaluated by contacting with their relatives.

Results: Our study is the first study which evaluates the association between HRQoL and long-term survival in patients with STEMI. The mean age was 56.96 ± 12.61 and 81 (88%) of the population were males. Mortality was observed in 12 patients after 5 years. The mean Index score was 0.903 ± 0.145 and the mean Visual Analog Scale (VAS) score was 80.58 ± 16.03. The means of the Index score and VAS score were lower in patients with mortality (p= 0.008 and p= 0.011, respectively). Both Index and VAS Scale scores were significantly associated with mortality (p= 0.002, ki-kare: 9.918; p= 0.008, ki-kare= 7.112, respectively). It was revealed by backward stepwise Cox regression analysis that the presence of an Index score ≤ 0.9 is associated with mortality [p= 0.005; HR= 5.546 (1.668-18.443)].

Conclusion: According to our analysis, lower HRQoL scores are associated with mortality. EQ5D index score is an independent predictor of the long-term mortality in patients with STEMI treated by PCI.

Keywords

• Health related quality of life,EQ5D,myocardial infarction,mortality

ST Yükselmeli Miyokart İnfarktüsü Hastalarında Yaşam Kalitesi ile 5 Yıllık Mortalite Arasındaki İlişki

Abstract

Amaç: Sağlık ile ilgili yaşam kalitesi ile mortalite ilişkisi ile ilgili sınırlı sayıda çalışma mevcuttur. Çalışmamızda perkütan koroner girişim (PKG) ile tedavi edilen ST yükselmeli miyokart infarktüsü (STYMİ) hastalarının yaşam kalitelerinin mortalite ile ilişkisini değerlendirmeyi amaçladık. 

Hastalar ve Yöntem: Çalışmaya akut STYMİ tanısı alıp primer PKG uygulanan ve 6. ay takipleri yapılan 92 hasta dahil edildi. Altıncı ayda yapılan klinik vizitte demografik ve klinik verileri toplandıktan sonra uluslararası geçerliliği olan ve Türkiye’de de akut koroner sendromlarda geçerlilik çalışması yapılmış olan EQ5D yaşam kalite ölçeği hastalar tarafından dolduruldu. Hastaların 5 yıl takiplerinin tamamlanmasını takiben veriler analiz edildi. Klinik vizit yapılamayan hastalar ya da bu hastaların yakınları mortaliteyi değerlendirmek için telefonla arandı. 

Bulgular: Bizim çalışmamız, STYMİ hastalarında yaşam kalitesi ile uzun dönem sağkalımın ilişkisini inceleyen ilk çalışmadır. Beş yıl takibi edilen 92 hastanın yaş ortalaması 56.96 ± 12.61 ve 81 (%88)’i erkek idi. Beş yıl sonunda 12 hastada mortalite görüldü. İndeks skor ortalaması 0.903 ± 0.145 ve vizüel analog ölçek (VAS) skor ortalaması 80.58 ± 16.03’dü. İndeks skor ve VAS skor ortalamaları mortalite olan hastalarda daha düşük bulundu (sırasıyla, p= 0.008, p= 0.011). Hem indeks skor hem de VAS skor anlamlı olacak şekilde mortalite ile ilişkiliydi (sırasıyla, p= 0.002, ki-kare= 9.918; p= 0.008, ki-kare= 7.112). Geriye doğru kademeli Cox regresyon analizi kullanılarak indeks skor ≤ 0.9 olmasının mortalite ile ilişkili olduğu ortaya çıkarıldı [p= 0.005; HR= 5.546 (1.668-18.443)].

Sonuç: Bizim analizlerimize göre, düşük sağlık ile ilgili yaşam kalitesi skorları mortalite ile ilişkilidir. EQ5D indeks skoru PKG ile tedavi edilen STYMİ hastalarında uzun dönem mortalitenin bağımsız bir ön gördürücüsüdür. 

Keywords

• Sağlıkla ilişkili yaşam kalitesi,EQ5D,miyokart infarktüsü,mortalite

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