Yang Juan, Jit Mark, Zheng Yaming, Feng Luzhao, Liu Xinxin, Wu Joseph T, Yu Hongjie
School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, 200032, China.
Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.
BMC Infect Dis. 2017 Oct 16;17(1):686. doi: 10.1186/s12879-017-2801-2.
Influenza causes considerable morbidity and mortality in China, but its impact on the health-related quality of life (HRQoL) has not been previously measured.
We conducted a retrospective telephone survey to assess the impact of influenza on the HRQoL among outpatients and inpatients using the EuroQoL EQ-5D-3 L instrument. Participants were individuals with laboratory-confirmed influenza infection registered by the National Influenza-like-illness Surveillance Network in 2013.
We interviewed 839 of 11,098 eligible influenza patients. After excluding those who were unable to complete the HRQoL for the registered influenza episode, 778 patients were included in the analysis. Both outpatients (n = 529) and inpatients (n = 249) most commonly reported problems with pain/discomfort (71.8% of outpatients and 71.9% of inpatients) and anxiety/depression (62.0% of outpatients and 75.1% of inpatients). For individual influenza outpatients, the mean health utility was 0.6142 (SD 0.2006), and the average quality adjusted life days (QALD) loss was 1.62 (SD 1.84) days. The HRQoL of influenza inpatients was worse (mean health utility 0.5851, SD 0.2197; mean QALD loss 3.51 days, SD 4.25) than that of outpatients (p < 0.05). The presence of underlying medical conditions lowered the HRQoL for both outpatients and inpatients (p < 0.05).
Influenza illness had a substantial impact on HRQoL. QALD loss due to an acute influenza episode in younger children was comparable to that due to enterovirus A71-associated hand, foot and mouth disease. Our findings are key inputs into disease burden estimates and cost-effectiveness evaluations of influenza-related interventions in China.
在中国，流感导致了相当高的发病率和死亡率，但此前尚未对其对健康相关生活质量（HRQoL）的影响进行评估。
我们进行了一项回顾性电话调查，使用欧洲五维健康量表（EuroQoL EQ-5D-3L）评估流感对门诊患者和住院患者HRQoL的影响。研究对象为2013年通过国家流感样疾病监测网络登记的实验室确诊流感感染患者。
在11098名符合条件的流感患者中，我们对839人进行了访谈。在排除那些无法完成针对已登记流感发作的HRQoL评估的患者后，778名患者被纳入分析。门诊患者（n = 529）和住院患者（n = 249）最常报告的问题是疼痛/不适（门诊患者中的71.8%和住院患者中的71.9%）以及焦虑/抑郁（门诊患者中的62.0%和住院患者中的75.1%）。对于个体流感门诊患者，平均健康效用为0.6142（标准差0.2006），平均质量调整生命天数（QALD）损失为1.62（标准差1.84）天。流感住院患者的HRQoL比门诊患者更差（平均健康效用0.5851，标准差0.2197；平均QALD损失3.51天，标准差4.25）（p < 0.05）。存在基础疾病会降低门诊患者和住院患者的HRQoL（p < 0.05）。
流感疾病对HRQoL有重大影响。幼儿因急性流感发作导致的QALD损失与因肠道病毒A71相关手足口病导致的损失相当。我们的研究结果是中国流感相关干预措施疾病负担估计和成本效益评估的关键输入信息。
