Patients with ischemic heart disease: quality of life predicts long-term mortality.
OBJECTIVE
We have investigated whether perceived quality of life has an impact on long-term survival after a cardiac event.


METHODS
Male (n = 316) and female (n = 97) patients were assessed by means of a self-administered quality of life questionnaire 1 year after either acute myocardial infarction (n = 296), coronary artery bypass grafting surgery (n = 99) or percutaneous coronary intervention (n = 18). Inclusion period was 1989-1991. Ten years after the last patient answered the 1-year questionnaire, mortality (status factor) up to census date was analysed using nine dimensions of quality of life as covariates (Cox regression).


RESULTS
At 1-year assessment, subjective general health (RR = 3.15), perceived arrhythmia (RR = 1.72), experience of sex life (RR = 1.55), perceived breathlessness (RR = 1.50) and experience of self-esteem (RR = 1.48) were all significantly related to death within the period up to census date.


CONCLUSIONS
The findings highlight that the patients' own experience of his or her quality of life, has a prognostic importance for long-term mortality after a cardiac event. Clinicians should be aware that a careful monitoring of perceived quality of life is an important part of good patient care.
Westin
L
L
Department of Medical Ethics, University of Lund, Sweden.
Nilstun
T
T
Carlsson
R
R
Erhardt
L
L
D000222:Adaptation, Physiological; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000706:statistics & numerical data; D002423:Cause of Death; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality* / Q000628:therapy*; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy; D011237:Predictive Value of Tests; D011379:Prognosis; D011788:Quality of Life; D018570:Risk Assessment; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D013548:Sweden; D013997:Time Factors; D016896:Treatment Outcome