Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
J Nephrol. 2013 Mar-Apr;26(2):366-74. doi: 10.5301/jn.5000153. Epub 2012 May 15.
Hemodialysis patients suffer from poor quality of life and survival. A retrospective cohort study was performed to examine the sex differences in self-reported quality of life and mortality in a Taiwanese hemodialysis cohort.
A total of 816 stable hemodialysis patients were included. Patients completed two questionnaires: the 36-item Short Form Health Survey Questionnaire (SF-36, Taiwan Standard Version 1.0) to assess health-related quality of life (HRQoL) and the Beck Depression Inventory (BDI, Chinese Version) to assess depressive mood. Mortality outcomes were recorded for a seven-year follow-up period.
After adjustment for confounding factors, women had significantly higher BDI scores (P=.003), lower physical functioning (P<.001), bodily pain (P<.001), mental health (P=0007), and physical component scale (PCS) scores (P<.001). There were 284 deaths recorded. In the Cox-proportional hazard model, women had significantly lower mortality than men (P<.001).
Women on hemodialysis had more depression-related symptoms and poor self-reported HRQoL, but better survival than men. The sex difference in psychological and HRQoL issues deserves greater concern because this relates to clinical care and further study.
血液透析患者的生活质量和生存率较差。本回顾性队列研究旨在探讨台湾血液透析队列中患者自我报告的生活质量和死亡率的性别差异。
共纳入 816 例稳定的血液透析患者。患者完成了两份问卷：36 项简明健康调查问卷（SF-36，台湾标准版 1.0），用于评估健康相关生活质量（HRQoL），贝克抑郁量表（BDI，中文版）用于评估抑郁情绪。记录了为期七年的随访期间的死亡率。
在调整混杂因素后，女性的 BDI 评分显著更高（P=.003），身体功能（P<.001）、躯体疼痛（P<.001）、心理健康（P=0007）和生理成分量表（PCS）评分（P<.001）显著更低。共记录到 284 例死亡。在 Cox 比例风险模型中，女性的死亡率显著低于男性（P<.001）。
血液透析的女性有更多与抑郁相关的症状和较差的自我报告 HRQoL，但生存状况优于男性。在心理和 HRQoL 问题上的性别差异值得更多关注，因为这与临床护理和进一步的研究有关。
