ESSEC Business School, Avenue Bernard Hirsch, 95021, Cergy-Pontoise Cedex, France.
Hôpital Louis Mourier, Assistance Publique Hôpitaux de Paris, Colombes, France.
Health Qual Life Outcomes. 2018 Feb 2;16(1):28. doi: 10.1186/s12955-018-0854-6.
Community Acquired Pneumococcal Pneumonia is a lung infection that causes serious health problems and can lead to complications and death. The aim of this study was to observe and analyze health related quality of life after a hospital episode for patients with community acquired pneumococcal pneumonia in France.
A total of 524 individuals were enrolled prospectively in the study and were followed for 12 months after hospital discharge. Presence of streptococcus pneumoniae was confirmed by microbiological sampling. Quality of life was reported at four different points of time with the EQ-5D-3 L health states using the French reference tariff. Complete data on all four periods was available for 269 patients. We used descriptive and econometric analysis to assess quality of life over time during follow-up, and to identify factors that impact the utility indexes and their evolution through time. We used Tobit panel data estimators to deal with the bounded nature of utility values.
Average age of patients was 63 and 55% of patients were men. Negative predictors of quality of life were the severity of the initial event, history of pneumonia, smokers, age and being male. On average, quality of life improved in the first 6 months after discharge and stabilized beyond. At month 1, mean utility index was 0.53 (SD: 0.34) for men and 0.45 (SD: 0.34) for women, versus mean of 0.69 (SD: 0.33) and 0.70 (SD: 0.35) at Month 12. "Usual activities" was the dimension the most impacted by the disease episode. Utilities for men were significantly higher than for women, although male patients were more severe. Individuals over 85 years old did not improve quality of life during follow-up, and quality of life did not improve or deteriorated for 34% of patients. We found that length of hospital stay was negatively correlated with quality of life immediately after discharge.
This study provides with evidence that quality of life after an episode of community acquired pneumococcal pneumonia improves overall until the sixth month after hospital discharge, but older patients with previous history of pneumonia may not experience health gains after the initial episode.
社区获得性肺炎是一种肺部感染，可导致严重的健康问题，并可能导致并发症和死亡。本研究的目的是观察和分析法国社区获得性肺炎患者住院后的健康相关生活质量。
共前瞻性纳入 524 名患者进行研究，并在出院后 12 个月进行随访。通过微生物采样证实肺炎链球菌的存在。使用法国参考关税，使用 EQ-5D-3L 健康状况报告了四个不同时间点的生活质量。共有 269 名患者完整记录了所有四个时期的数据。我们使用描述性和计量经济学分析来评估随访期间随时间推移的生活质量，并确定影响效用指数及其随时间演变的因素。我们使用 Tobit 面板数据估计器来处理效用值的有界性质。
患者的平均年龄为 63 岁，55%的患者为男性。生活质量的负面预测因素是初始事件的严重程度、肺炎病史、吸烟者、年龄和性别。平均而言，出院后前 6 个月生活质量有所改善，之后稳定。在第 1 个月，男性的平均效用指数为 0.53（SD：0.34），女性为 0.45（SD：0.34），而在第 12 个月，男性为 0.69（SD：0.33），女性为 0.70（SD：0.35）。“日常活动”是受疾病影响最严重的维度。男性的效用明显高于女性，尽管男性患者的病情更严重。85 岁以上的个体在随访期间生活质量没有改善，34%的患者生活质量没有改善或恶化。我们发现，住院时间与出院后立即的生活质量呈负相关。
本研究提供了证据表明，社区获得性肺炎发作后的生活质量总体上会在出院后第六个月之前得到改善，但有肺炎既往史的老年患者在初次发作后可能不会获得健康收益。
