Magid David J, Houry Debra, Ellis Jennifer, Lyons Ella, Rumsfeld John S
Clinical Research Unit, Colorado Permanente Medical Group, Denver, CO, USA.
Ann Emerg Med. 2004 May;43(5):551-7. doi: 10.1016/j.annemergmed.2003.11.021.
The objective of this study is to evaluate health-related quality of life as a risk factor for subsequent emergency department (ED) utilization in a cohort of patients with asthma.
We conducted a 1-year prospective cohort study of 1,406 adult asthma patients. Baseline physical and mental health status were measured using the Physical Component Summary and Mental Component Summary scores from the Short Form-12 health status survey. Asthma-specific health-related quality of life was measured with the mini-Asthma Quality of Life Questionnaire. Multivariable regression was used to assess the independent association between baseline Physical Component Summary, Mental Component Summary, and Asthma Quality of Life Questionnaire scores and asthma-related ED visits during the subsequent year.
During the 1-year follow-up period, 116 patients made at least 1 asthma-related ED visit. After adjustment for multiple sociodemographic and clinical factors, both the Physical Component Summary score (odds ratio [OR] 1.72; 95% confidence interval [CI] 1.46 to 2.02) and the Asthma Quality of Life Questionnaire score (OR 1.34; 95% CI 1.18 to 1.52) were associated with subsequent asthma-related ED utilization. In contrast, overall mental health status was not associated with subsequent asthma-related ED utilization (OR 1.17; 95% CI 0.96 to 1.44).
Overall physical health status and asthma-specific quality of life predict subsequent ED utilization. Health-related quality of life may be useful in identifying patients at increased risk for asthma exacerbation requiring emergency care.
本研究的目的是评估健康相关生活质量作为哮喘患者队列中后续急诊就诊的危险因素。
我们对1406名成年哮喘患者进行了为期1年的前瞻性队列研究。使用简短健康调查问卷12项的生理健康总结分和心理健康总结分来测量基线时的身心健康状况。使用小型哮喘生活质量问卷来测量哮喘特异性健康相关生活质量。多变量回归用于评估基线生理健康总结分、心理健康总结分和哮喘生活质量问卷得分与随后一年中与哮喘相关的急诊就诊之间的独立关联。
在1年的随访期内,116名患者至少进行了1次与哮喘相关的急诊就诊。在对多个社会人口统计学和临床因素进行调整后,生理健康总结分(优势比[OR]1.72;95%置信区间[CI]1.46至2.02)和哮喘生活质量问卷得分(OR 1.34;95%CI 1.18至1.52)均与随后与哮喘相关的急诊就诊有关。相比之下,总体心理健康状况与随后与哮喘相关的急诊就诊无关(OR 1.17;95%CI 0.96至1.44)。
总体身体健康状况和哮喘特异性生活质量可预测后续急诊就诊情况。健康相关生活质量可能有助于识别哮喘加重需要紧急护理风险增加的患者。