Benito Pau, Vashakidze Sergo, Gogishvili Shota, Nikolaishvili Keti, Despuig Albert, Tukvadze Nestan, Shubladze Natalia, Avaliani Zaza, Vilaplana Cristina
Experimental Tuberculosis Unit (UTE), Fundació Institut Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona (UAB), Badalona, Spain.
Faculty of Health and Life Sciences (FCSV), Universitat Pompeu Fabra and UAB, Barcelona, Spain.
ERJ Open Res. 2020 Aug 31;6(3). doi: 10.1183/23120541.00083-2020. eCollection 2020 Jul.
This study aimed to determine the health-related quality of life (HRQoL) of patients with pulmonary tuberculosis (TB) and to assess its change after a therapeutic surgical procedure. In this scenario, the purpose was to elucidate and quantify the effect of various demographic, epidemiological, clinical, surgical and psychosocial details on this variable. A prospective cohort of 40 patients undergoing therapeutic surgery for pulmonary TB (Study of Human Tuberculosis Lesions (SH-TBL) cohort) was recruited in Tbilisi, Georgia, between 2016 and 2018. HRQoL was assessed by administering the St George's Respiratory Questionnaire (SGRQ) and a novel psychosocial questionnaire, the BCN-Q, both at baseline and at 6 months post-surgery. A statistically and clinically significant improvement in the SGRQ total score was observed at follow-up, although it did not reach the values found for the healthy population. The differences between time points were statistically significant for the following groups: women, age <40 years, body mass index ≥20 kg·m, nonsmokers, drug-susceptible and drug-resistant participants, both new and relapsed patients, early culture negativisation, cases with a single lesion, either lesions <35 mm or ≥35 mm, and lesion, lobe and lung resections. The analysis of BCN-Q together with the SGRQ showed that several of its items, such as marital status, living conditions, nutrition, employment, external support, certain attitudes towards the healthcare system, emotional burden and sleep troubles, can impact HRQoL. These results highlight the benefit of adjuvant therapeutic surgery for pulmonary TB in selected patients in terms of HRQoL and suggest that a comprehensive approach including demographic, epidemiological, clinical and psychosocial variables may more accurately predict TB evolution and prognosis.
本研究旨在确定肺结核（TB）患者的健康相关生活质量（HRQoL），并评估治疗性手术后其变化情况。在此情况下，目的是阐明并量化各种人口统计学、流行病学、临床、手术及社会心理细节对此变量的影响。2016年至2018年期间，在格鲁吉亚第比利斯招募了40名接受肺结核治疗性手术的患者组成前瞻性队列（人类结核病变研究（SH-TBL）队列）。通过在基线和术后6个月时使用圣乔治呼吸问卷（SGRQ）和一种新型社会心理问卷BCN-Q来评估HRQoL。随访时观察到SGRQ总分有统计学和临床意义的改善，尽管未达到健康人群的数值。以下几组在时间点之间的差异具有统计学意义：女性、年龄<40岁、体重指数≥20 kg·m、非吸烟者、药物敏感和耐药参与者、新发病例和复发患者、早期培养转阴、单发病变病例、病变<35 mm或≥35 mm的病例以及病变、肺叶和肺切除术。BCN-Q与SGRQ的分析表明，其几个项目，如婚姻状况、生活条件、营养、就业、外部支持、对医疗系统的某些态度、情感负担和睡眠问题，会影响HRQoL。这些结果突出了辅助性治疗性手术对特定肺结核患者HRQoL的益处，并表明包括人口统计学、流行病学、临床和社会心理变量的综合方法可能更准确地预测结核病的进展和预后。
