Correlation between exercise, personal income level and health-related quality of life in patients with newly diagnosed stable angina

Background:Stable angina is one of the most common clinical types of coronary artery disease(CAD)and associated with poor health-related quality of life(HRQL).However,few studies have evaluated the risk factors associated with HRQL in patients with newly diagnosed stable angina.Methods:A cross-sectional survey was conducted with 342 consecutive outpatients with newly diagnosed stable angina from October 2017 to January 2018 at the Second Affiliated Hospital of Army Medical University,Chongqing,China.Eight dimensions of HRQL were evaluated via the 36-item Short-Form Health Survey,including physical functioning,role limitation due to physical problems,bodily pain,general health,vitality,social functioning,role limitation due to emotional problems,and mental health.Physical and mental component summaries were calculated.Multiple stepwise regression was performed to determine the factors associated with HRQL.Results:Patients who were older,were females,did not exercise,had lower educational levels,had lower monthly incomes,had smoking/drinking habits,and had diabetes,hypertension,or hyperlipemia showed lower physical HRQL scores,while those who were older with lower educational levels and lower monthly incomes showed lower mental HRQL scores.The results of the multiple stepwise regression analyses showed that physical and mental HRQL were positively correlated with exercise and monthly income and negatively associated with age.Patients with monthly income≥5000 Yuan showed higher HRQL scores than those with monthly income<5000 Yuan.Sleep quality and drinking were negatively associated with physical,but not mental HRQL.Conclusions:Our findings indicated that exercise and personal income level,both modifiable factors,were positively associated with physical and mental HRQL.These findings could have implications for clinical suggestions and strategies to improve HRQL in patients with stable angina.

Effects of Preoperative Risk Stratification on Direct In-hospital Costs for Chinese Patients with Coronary Artery Bypass Graft:A Single Center Analysis

The purpose of this study was to analyze the components of inpatient costs for coronary artery bypass graft(CABG)according to preoperative risk stratification and to provide evidence for improvement of diagnosis-related groups(DRGs)payment.All patients(n=458)receiving an isolated CABG between January 2014 and December 2016 in a tertiary referral center,in southwest China,were analyzed.Hospital mortality was predicted by the EuroSCORE Ⅱ for each patient. The patients were subdivided into two groups according to the observed mortality(1.97%,9/458):a high-risk group(group H,predicted mortality≥1.97%)and a low-risk group(group L,predicted mortality<1.97%).Clinical outcomes,resource use,in-hospital direct costs,and reimbursement expenses were compared between the two groups.Significant differences existed between group L and group H in postoperative mortality(0.4% vs.3.4%;P=0.02),postoperative complications(10.6% vs.45.7%;P<0.001),postoperative length of hospital stay(17.5±4.9 days vs.18.8±6.5 days,P=0.01),in-hospital costs($20 256±3096vs.$23 334±6332;P<0.001),and reimbursement expenses($7775±2627 vs.$9639±3917;P<0.001).In general,a higher EuroSCORE Ⅱ was significantly associated with a worse clinical outcome and increased costs.The CABG cost data provide evidence for improvement of DRGs payment. Key words:coronary artery bypass graft;risk stratification;hospital costs;medical insurance