急性心肌梗塞病人健康相關生活品質及調整品質後存活分析(2/2)
Date Issued
2002
Date
2002
Author(s)
廖朝崧
DOI
902314B002295
Abstract
The prevalence rate of atherosclerotic
disease increased rapidly with the trend of
aging population in Taiwan. Choice of
proper intervention therapy or modification
of risk factors in high-risk population should
be paid much attention to.
We reviewed medical records and
retrospectively recruited a cohort of 1,600
patients with acute myocardial infarction in
the National Taiwan University Hospital
(NTUH) during 1986-1999. We tried to
develop the disease-specific quality of life
(QOL) questionnaire through focus groups
in patients with acute myocardial infarction
(AMI) in NTUH. However, the plan should
be delayed due to the basic requirement of
multi-national nature for the development of
disease-specific questionnaires for
WHOQOL. And, the Taiwan version of
WHOQOL BREF plus AMI-specific QOL
questionnaire will be used to evaluate the
quality of life (HRQL) in the patients cohort
of AMI who has survived in the next year.
The quality adjusted survival time (QAST)
will be calculated from the survival analysis
combined with HRQL score from patients
with AMI. The efficacy and quality adjusted
life expectancy (QALE) for different
treatment modalities of intervention
(invasive and noninvasive) will be analyzed
and compared. So far, we have
accomplished the analysis for prognostic
factors on survival.
Cox proportional hazard model analysis
revealed that female, medical treatment only,
higher Killip classification, history of CVA
(cerebrovascular apoplexy) and DM
(diabetes mellitus), lower cardiac output,
atrial fibrillation had poor survival time.
Further analysis for intervention strategies,
we identified elective PTCA had better
prognosis, and treatments with coronary
bypass graft surgery and thrombolytic
therapy could not provide better survival
outcome.
In conclusion, this study was designed to
evaluate the patients of AMI in a
hospital-based cohort in NTUH with the
Taiwan version of WHOQOL BREF
questionnaire of AMI. The multiple Cox
proportional hazard metal analysis identified
some interesting risk factors, which may
provide an important reference for choice of
treatment for patients with AMI in Taiwan.
Regarding the QALE and cost-effectiveness
of different treatment strategies for AMI will
be scheduled in the next year.
Subjects
Survival analysis
Acute
myocardial infarction
myocardial infarction
Quality adjusted life
expectancy
expectancy
SDGs
Publisher
臺北市：國立臺灣大學醫學院內科
Type
report
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