Health related quality of life of patients following mechanical valve replacement surgery for rheumatic mitral stenosis in Tanzania.

Autor: Mutagaywa RK; School of Medicine, Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, P.O. BOX 5539, Dar es Salaam, Tanzania. reubenmutagaywa@yahoo.com.; Muhimbili Orthopaedic Institute, Dar es Salaam, Tanzania. reubenmutagaywa@yahoo.com.; Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania. reubenmutagaywa@yahoo.com.; Division of Heart and Lung, Department of Cardiology, University Medical Centre Utrecht, Utrecht, Netherlands. reubenmutagaywa@yahoo.com., Cramer MJ; Division of Heart and Lung, Department of Cardiology, University Medical Centre Utrecht, Utrecht, Netherlands., Chillo P; School of Medicine, Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, P.O. BOX 5539, Dar es Salaam, Tanzania.; Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania., Khamis RH; School of Medicine, Department of Surgery (Cardiothoracic& vascular section), Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania., Boniface R; Muhimbili Orthopaedic Institute, Dar es Salaam, Tanzania., Muhozya A; Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania., Barongo A; Department of Paediatrics, Mwananyamala Regional Referral Hospital, Dar es Salaam, Tanzania., Byomuganyizi M; School of Medicine, Department of Surgery (Cardiothoracic& vascular section), Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania., Kwesigabo G; School of Public Health, Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania., Kamuhabwa A; School of Pharmacy, Department of Pharmacology and Clinical Pharmacy and Pharmacology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania., Nyangasa B; Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania., Kisenge P; Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania., Chamuleau S; Heart Center, Department of Cardiology and Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centre, Amsterdam, Netherlands.
Jazyk: angličtina
Zdroj: Journal of cardiothoracic surgery [J Cardiothorac Surg] 2023 Apr 21; Vol. 18 (1), pp. 159. Date of Electronic Publication: 2023 Apr 21.
DOI: 10.1186/s13019-023-02235-z
Abstrakt: Background: The assessment of outcomes of interventions based on the patient's perspective using patient-reported outcome measures (PROMs) has been increasingly highlighted in clinical practice. However, health related quality of life (HRQoL), one of the common constructs measured by PROMs remain unknown among patients after heart valve replacement (HVR) in Tanzania.
Objectives: To assess the HRQoL amongst patients operated on for rheumatic mitral stenosis at Jakaya Kikwete Cardiac Institute (JKCI).
Methods: A prospective study of patients operated on due to rheumatic mitral stenosis at JKCI from January 2020 to April 2021 was undertaken. The HRQoL was assessed by using the MacNew questionnaire, addressing three domains (physical, emotional, and social function); the score ranges from 0 to 7. We categorized HRQoL as low (mean score ≤ 4.9), moderate (5-6) and high (> 6). We analysed several sociodemographic and clinical variables for HRQoL.
Results: Out of 54 patients, there were 34 females and 20 males. Their mean (± SD) age was 37.98 (± 12.58) years. The reliability of translated Kiswahili version of MacNew was good. The mean (± SD) global scores were 3.47 ± 0.59, 4.88 ± 0.71 and 6.14 ± 0.50 preoperatively, at 3 months and 6 months respectively (p-values < 0.001 preoperatively vs. 3 months, preoperatively vs. 6 months and at 3 months vs. 6 months). The median of individual mean difference HRQoL score pre-operatively and at 6 months was 2.67. The preoperative and 6 months mean difference HRQoL scores were higher among patients with vs. without atrial fibrillation (2.95 ± 0.59 vs. 2.45 ± 0.53, p = 0.003) and those on anticoagulants (preoperatively) vs. not on anticoagulants (3.14 ± 0.58 vs. 2.57 ± 0.57, 0.009). The mean difference HRQoL scores were similar for sociodemographic and other clinical parameters, including those with stroke vs. without stroke.
Conclusion: Six months after HVR the overall MacNew HRQoL scores improved markedly. This improvement in HRQoL was regardless of the presence of comorbidities (e.g. stroke and atrial fibrillation) which underscores the importance of considering valvular surgery if they fit the criteria. Clinicians and researchers in low-resource settings should collaborate to promote the utilization of PROMs in the routine care of patients.
(© 2023. The Author(s).)
Databáze: MEDLINE
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