| Objective To understand the statuses of anxiety during perioperative percutaneous coronary intervention(PCI),the quality of life and rehospitalization due to cardiovascular diseases after PCI and analyze the relationship between the perioperative anxiety and the quality of life(QOL),rehospitalization due to cardiovascular diseases in patients undergoing elective PCI.Methods This is a prospective study.A convenience sampling method was used to recruit the participants.A total of 220 patients with CHD who underwent elective PCI in a Changshu hospital from December 2018 to May 2019 were selected as study subjects.The collected general information about patients as follows:(1)age,gender,educational status,whether be on the job,history of smoking,body mass index(BMI);(2)Clinical data including left ventricular ejection fraction(LVEF),high-sensitivity C-reactive protein(Hs-CRP),total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)were collected,family history of CHD,history of hypertension or diabetes;(3)The Self-rating Anxiety Scale(SAS)was scored to collect the levels of anxiety peroperative PCI at appointment for PCI(T1),3 days before PCI(T2),1 day before PCI(T3)and 1 day after PCI(T4);(4)The Seattle Angina Questionnaire(SAQ)including 5 dimensions as follows:physical limitation(PL),anginal stability(AS),anginal frequency(AF),treatment satisfaction(TS)and disease perception(DP)was scored to collect the quality of life at 3 months and 6 months postoperatively;(5)the rehospitalization due to cardiovascular diseases postoperatively during 6 months was collected.The data were analyzed using SPSS 23.0.The continuous variables in normal distribution were represented as(x±s),and compared between two groups using the t test.The categorical or rand variables were expressed as percentage,and compared between groups by the chi-square test or Fisher's exact test.The effect of anxiety on the quality of life and rehospitalization rate were analyzed using multivariate logistic regression.Bilateral P<0.05 was considered as statistically significant.Results A total of 220 patients were investigated in this study.Eight patients were dropped during the follow-up.Lastly,the data of the 212 patients were analyzed statistically.(1)The levels of anxiety at each times:T1,the score of SAS was 37.99 ± 5.04,6 cases were with mild anxiety;T2,the score was 44.79 ± 5.38,mild,moderate and severe anxiety were 32 cases,2 cases and 1 case,respectively;T3,the score was 45.68 ± 6.66,mild and moderate anxiety were 29 and 12 cases,respectively;T4,the score was 40.69±7.69,mild and moderate anxiety were 21 and 5 cases,respectively.(2)The scores of the SAQ at 3 and 6 months after PCI were 68.09 ± 7.77 and 70.35±7.25,respectively.The scores of dimensions of SAQ at 3 and 6 months were as following:PL 65.09 ± 13.38 and 69.73± 11.14;AS 80.42± 27.65 and 81.13±18.95;AF 73.07±12.75 and 70.09 ± 12.88;TS 57.14 ± 15.10 and 60.61 ± 13.72;DP 64.70± 9.87 and 70.17±8.02.(3)During 6 month follow-up,54 patients were re-hospitalized,with a re-hospitalization rate of 25.5%.Among of them,14 patients(6.6%)suffered from recurrent angina,6 patients(2.83%)from cardiac insufficiency,26 patients(12.26%)from hypertension,and 8 Cases(3.77%)from arrhythmia.(4)Relationships between the peroperative anxiety and the QOL postoperatively:At T1,the score of AS at 3 months showed a statistically significant difference between the patients with or without anxiety(t?8.890,P=0.003),At T2,the score of AF at 6 months showed a statistically significant difference between the patients with or without anxiety(t?1.174,P?0.043).After adjusting for other confounding factors,the perioperative anxiety had no statistically significant effect on the QOL postoperatively.(5)Relationships between the peroperative anxiety and rehospitalization due to cardiovascular diseases postoperatively:Rehospitalization rates presented statistically significant differences between the patients with or without anxiety at T2(?2=4.459,P=0.001),T3(?2?3.354,P=0.001)and T4(?2=-2.237,P=0.026).After adjusting for other confounding factors,the perioperative anxiety at T2(B=1.445,P?0.010,95%CI:1.409-12.773)and T4(B=1.587,P=0.042,95%CI:0.044-0.941)became the risk factors of rehospitalization due to cardiovascular diseases postoperatively during 6 months follow-up.Conclusions 1.During the perioperative period of elective PCI,the anxiety levels of CHD patients fluctuates dynamically which reached a peak at 1d before PCI;2.Patients with anxiety at the time of appointment for PCI had a poor quality of life in the dimension of stable state of angina at 3m after PCI;patients with anxiety at 3d before PCI had a poor quality of life in the dimension of angina attacks at 6m after PCI;Patients with anxiety at the time of appointment had less stable angina at 3 months after operation,and patients with anxiety at 3 days before operation had more severe angina attacks at 6 months after operation;3.The rehospitalization rate of patients with coronary heart disease within 6 months was 25.5%,of which hypertension was 12.26%and angina was only 6.6%.Anxiety at 3 days before operation and no anxiety at 1 day after operation were closely related to the rate of cardiovascular rehospitalization within 6 months after operation,and were independent risk factors.It is suggested that psychological intervention should be focused on these two time points in the future. |
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