客观评估慢性鼻-鼻窦炎患者的总体生活质量可揭示疾病修饰因素。

Unbiased Measure of General Quality of Life in Chronic Rhinosinusitis Reveals Disease Modifiers.

机构信息

Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A.

Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, U.S.A.

出版信息

Laryngoscope. 2021 Jun;131(6):1206-1211. doi: 10.1002/lary.29139. Epub 2020 Oct 2.

DOI:10.1002/lary.29139

PMID:33006402

Abstract

INTRODUCTION

Chronic rhinosinusitis (CRS) is associated with a significant decrease in general health-related quality of life (QOL). The EuroQol 5-dimensional questionnaire measures general health-related quality of life through a health utility value (EQ-5D HUV)-based on five domains reflecting mobility, self-care, activities of daily life, pain/discomfort, and anxiety/depression-and an unbiased visual analog scale (EQ-5D VAS). We sought to identify characteristics of CRS patients with a high EQ-5D HUV but low EQ-5D VAS score.

MATERIALS AND METHODS

Retrospective cross-sectional study of 300 CRS patients with EQ-5D HUV equal to 1.0 (reflecting perfect health). All patients completed a 22-item Sinonasal Outcome Test (SNOT-22)-from which nasal, sleep, ear/facial discomfort, and emotional subdomain scores were calculated, as well as the EQ-5D. Low EQ-5D VAS was defined as a score less than 80.

RESULTS

On multivariate analysis, low EQ-5D VAS was associated with only the SNOT-22 sleep subdomain score (odds ratio [OR] = 1.07, 95%CI: 1.02-1.12, P = .003). Comorbid asthma was also associated with lower EQ-5D VAS (OR = 2.16, 95%CI: 1.02-4.59, P = .045). In contrast, polyps were negatively associated with having a lower EQ-5D VAS (OR = 0.34, 95%CI: 0.17-0.69, P = .003).

CONCLUSION

There are patients with perfect general health-related QOL according to a health utility value-based methodology (like the EQ-5D HUV) who report low general health-related QOL on an unbiased measure like the EQ-5D VAS. In CRS patients with perfect EQ-5D HUV, poor sleep and asthma were associated with low QOL on the EQ-5D VAS, while polyps were negatively associated with low QOL.

LEVEL OF EVIDENCE

3 Laryngoscope, 131:1206-1211, 2021.

摘要

简介

慢性鼻-鼻窦炎（CRS）与总体健康相关生活质量（QOL）显著下降有关。EuroQol 5 维问卷通过健康效用值（EQ-5D HUV）衡量总体健康相关 QOL，该值基于反映活动能力、自理能力、日常生活活动、疼痛/不适和焦虑/抑郁的五个领域-以及无偏视觉模拟量表（EQ-5D VAS）。我们试图确定 EQ-5D HUV 高但 EQ-5D VAS 评分低的 CRS 患者的特征。

材料和方法

对 300 名 EQ-5D HUV 等于 1.0（反映完美健康）的 CRS 患者进行回顾性横断面研究。所有患者均完成了 22 项鼻-鼻窦结局测试（SNOT-22）-其中计算了鼻腔、睡眠、耳/面部不适和情绪子域评分，以及 EQ-5D。低 EQ-5D VAS 的定义为评分低于 80。

结果

多变量分析显示，低 EQ-5D VAS 仅与 SNOT-22 睡眠子域评分相关（比值比[OR] = 1.07，95%CI：1.02-1.12，P =.003）。合并哮喘也与较低的 EQ-5D VAS 相关（OR = 2.16，95%CI：1.02-4.59，P =.045）。相比之下，息肉与较低的 EQ-5D VAS 呈负相关（OR = 0.34，95%CI：0.17-0.69，P =.003）。

结论

根据基于健康效用值的方法（如 EQ-5D HUV），存在具有完美总体健康相关 QOL 的患者，但在像 EQ-5D VAS 这样的无偏测量中报告总体健康相关 QOL 较低。在具有完美 EQ-5D HUV 的 CRS 患者中，睡眠不佳和哮喘与 EQ-5D VAS 上的低 QOL 相关，而息肉与低 QOL 呈负相关。