Abstract
STUDY OBJECTIVE--The aim was to determine the loss of quality of life following admission to hospital with suspected myocardial infarction. DESIGN--The study involved a cohort of admissions, with interview and follow up for 100 days. Main outcome measures were the quality of life prior to admission and at each stage of convalescence, estimated using the Rosser-Kind matrix: the calculated number of quality adjusted days during a 100 d follow up period. SETTING--The study took place in a teaching hospital in Scotland. PATIENTS--206 patients were admitted with suspected acute myocardial infarction. Infarction was confirmed in 160 (Q wave infarcts 100, non-Q-wave infarcts 60), and unconfirmed in 46. MAIN RESULTS--The quality of life scores before the suspected heart attack were similar for patients whose final diagnosis was Q wave infarction, non-Q-wave infarction, or non-infarction. Of the 160 patients with confirmed infarction, only 54 (34%) had regained their previous quality of life scores at the end of 100 days, compared with 26 of 46 (57%) patients with unconfirmed infarction (p < 0.01). The mean numbers of quality adjusted days lost to patients with Q wave infarction, non-Q-wave infarction, and non-infarction were 17.0, 12.4, and 5.9 respectively (infarction v non-infarction, p < 0.0001). Measurements of both quantity and quality of life contributed to these results. CONCLUSIONS--The number of quality adjusted days lost after acute myocardial infarction is a practicable measurement that is relevant to patients' lives. It might be suitable as an outcome measure for clinical trials of thrombolytic therapy.
Full text
PDF




Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Benson T. J. Classification of disability and distress by ward nurses: a reliability study. Int J Epidemiol. 1978 Dec;7(4):359–361. doi: 10.1093/ije/7.4.359. [DOI] [PubMed] [Google Scholar]
- Bergner M., Bobbitt R. A., Carter W. B., Gilson B. S. The Sickness Impact Profile: development and final revision of a health status measure. Med Care. 1981 Aug;19(8):787–805. doi: 10.1097/00005650-198108000-00001. [DOI] [PubMed] [Google Scholar]
- Chesebro J. H., Knatterud G., Roberts R., Borer J., Cohen L. S., Dalen J., Dodge H. T., Francis C. K., Hillis D., Ludbrook P. Thrombolysis in Myocardial Infarction (TIMI) Trial, Phase I: A comparison between intravenous tissue plasminogen activator and intravenous streptokinase. Clinical findings through hospital discharge. Circulation. 1987 Jul;76(1):142–154. doi: 10.1161/01.cir.76.1.142. [DOI] [PubMed] [Google Scholar]
- Editorial: Major changes made by Criteria Committee of the New York Heart Association. Circulation. 1974 Mar;49(3):390–390. doi: 10.1161/01.cir.49.3.390. [DOI] [PubMed] [Google Scholar]
- Goldman L., Hashimoto B., Cook E. F., Loscalzo A. Comparative reproducibility and validity of systems for assessing cardiovascular functional class: advantages of a new specific activity scale. Circulation. 1981 Dec;64(6):1227–1234. doi: 10.1161/01.cir.64.6.1227. [DOI] [PubMed] [Google Scholar]
- Harris J. QALYfying the value of life. J Med Ethics. 1987 Sep;13(3):117–123. doi: 10.1136/jme.13.3.117. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hogg K. J., Gemmill J. D., Burns J. M., Lifson W. K., Rae A. P., Dunn F. G., Hillis W. S. Angiographic patency study of anistreplase versus streptokinase in acute myocardial infarction. Lancet. 1990 Feb 3;335(8684):254–258. doi: 10.1016/0140-6736(90)90069-h. [DOI] [PubMed] [Google Scholar]
- Hunt S. M., McKenna S. P., McEwen J., Backett E. M., Williams J., Papp E. A quantitative approach to perceived health status: a validation study. J Epidemiol Community Health. 1980 Dec;34(4):281–286. doi: 10.1136/jech.34.4.281. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mahler D. A., Weinberg D. H., Wells C. K., Feinstein A. R. The measurement of dyspnea. Contents, interobserver agreement, and physiologic correlates of two new clinical indexes. Chest. 1984 Jun;85(6):751–758. doi: 10.1378/chest.85.6.751. [DOI] [PubMed] [Google Scholar]
- Rawles J. Castigating QALYs. J Med Ethics. 1989 Sep;15(3):143–147. doi: 10.1136/jme.15.3.143. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rosser R. M., Watts V. C. The measurement of hospital output. Int J Epidemiol. 1972 Winter;1(4):361–368. doi: 10.1093/ije/1.4.361. [DOI] [PubMed] [Google Scholar]
- Rosser R., Kind P. A scale of valuations of states of illness: is there a social consensus? Int J Epidemiol. 1978 Dec;7(4):347–358. doi: 10.1093/ije/7.4.347. [DOI] [PubMed] [Google Scholar]
- Sackett D. L., Chambers L. W., MacPherson A. S., Goldsmith C. H., Mcauley R. G. The development and application of indices of health: general methods and a summary of results. Am J Public Health. 1977 May;67(5):423–428. doi: 10.2105/ajph.67.5.423. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Smith A. Qualms about QALYs. Lancet. 1987 May 16;1(8542):1134–1136. doi: 10.1016/s0140-6736(87)91685-0. [DOI] [PubMed] [Google Scholar]
- Wilcox R. G., von der Lippe G., Olsson C. G., Jensen G., Skene A. M., Hampton J. R. Trial of tissue plasminogen activator for mortality reduction in acute myocardial infarction. Anglo-Scandinavian Study of Early Thrombolysis (ASSET). Lancet. 1988 Sep 3;2(8610):525–530. doi: 10.1016/s0140-6736(88)92656-6. [DOI] [PubMed] [Google Scholar]
- Williams A. Economics of coronary artery bypass grafting. Br Med J (Clin Res Ed) 1985 Aug 3;291(6491):326–329. doi: 10.1136/bmj.291.6491.326. [DOI] [PMC free article] [PubMed] [Google Scholar]
