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胰腺癌胰十二指肠切除术后患者衍生效用值与生活质量的相关性

Correlation of patient-derived utility values and quality of life after pancreaticoduodenectomy for pancreatic cancer.

作者信息

Warnick Stephen J, Velanovich Vic

机构信息

Division of General Surgery, Henry Ford Hospital, Detroit, MI, USA.

出版信息

J Am Coll Surg. 2006 Jun;202(6):906-11. doi: 10.1016/j.jamcollsurg.2006.02.032.

Abstract

BACKGROUND

Utility value (UV) represents the "value" that a patient places on a given health state and can be closely associated with quality of life. The purpose of this study was to determine if UV and quality of life are correlated after pancreaticoduodenectomy for pancreatic adenocarcinoma and to assess quality of life after pancreaticoduodenectomy.

STUDY DESIGN

Patients who underwent pancreaticoduodenectomy for pancreatic cancer were interviewed using the 36-item Short Form Health Survey, which measures 8 domains of quality of life. Patients assessed their current health state by rating their present health from 0 (which was equivalent to death) to 100 (which was equivalent to prefect health), and by a time-exchange (TE) method that asked how many years of their present life they would be willing to exchange for perfect health. Statistical analysis consisted of linear regression analysis and Mann-Whitney U test.

RESULTS

Twenty patients were interviewed. The UVs correlated with the TE (p = 0.003, r = -0.63), and 6 of 8 36-item Short Form Health Survey domains: physical functioning (p < 0.00001, r = 0.82), role-physical (p = 0.005, r = 0.61), bodily pain (p = 0.003, r = 0.63), general health (p = 0.00001, r = 0.81), vitality (p = 0.01, r = 0.54), and mental health (p = 0.03, r = 0.5). The TE score correlated with the physical functioning (p = 0.06, r = -0.59) and bodily pain (p = 0.05, r = -0.44) domains. There were significant differences in the UV, TE, physical functioning, role-physical, and role-emotional between patients less than 1 year and more than 1 year postoperative.

CONCLUSIONS

These data imply that patient-perceived health status and quality of life are linked and that quality-of-life scores after pancreaticoduodenectomy are better in patients more than 1 year postoperative.

摘要

背景

效用值(UV)代表患者对特定健康状态赋予的“价值”,且可能与生活质量密切相关。本研究的目的是确定胰腺癌胰十二指肠切除术后效用值与生活质量是否相关,并评估胰十二指肠切除术后的生活质量。

研究设计

对因胰腺癌接受胰十二指肠切除术的患者使用36项简明健康调查问卷进行访谈,该问卷测量生活质量的8个领域。患者通过将其当前健康状况从0(相当于死亡)到100(相当于完美健康)进行评分,以及通过时间交换(TE)方法,即询问他们愿意用当前生活的多少年去换取完美健康,来评估其当前健康状态。统计分析包括线性回归分析和曼-惠特尼U检验。

结果

对20名患者进行了访谈。效用值与时间交换相关(p = 0.003,r = -0.63),且与36项简明健康调查问卷8个领域中的6个相关:生理功能(p < 0.00001,r = 0.82)、生理角色(p = 0.005,r = 0.61)、身体疼痛(p = 0.003,r = 0.63)、总体健康(p = 0.00001,r = 0.81)、活力(p = 0.01,r = 0.54)和心理健康(p = 0.03,r = 0.5)。时间交换得分与生理功能(p = 0.06,r = -0.59)和身体疼痛(p = 0.05,r = -0.44)领域相关。术后不到1年和超过1年的患者在效用值、时间交换、生理功能、生理角色和情感角色方面存在显著差异。

结论

这些数据表明患者感知的健康状况与生活质量相关,且胰十二指肠切除术后1年以上患者的生活质量得分更好。

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