一个多民族亚洲间质性肺疾病队列中的健康相关生活质量
Health-related quality of life in a multiracial Asian interstitial lung disease cohort.
作者信息
Phua Grace, Tan Geak Poh, Phua Hwee Pin, Lim Wei-Yen, Neo Han-Yee, Chai Gin Tsen
机构信息
Lee Kong Chian School of Medicine, National Technological University, Singapore, Singapore.
Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore, Singapore.
出版信息
J Thorac Dis. 2022 Dec;14(12):4713-4724. doi: 10.21037/jtd-22-906.
BACKGROUND
Understanding health-related quality of life (HRQL) in patients with interstitial lung disease (ILD) provides insight into disease burden and treatment effects on patients' well-being. We examined HRQL in a multiracial Asian ILD cohort using the King's brief ILD (K-BILD) and EuroQol 5-dimension-3-level (EQ5D-3L) questionnaires and their associations with several clinical variables.
METHODS
This was a single-centre cross-sectional study of ILD patients in a university-affiliated tertiary public hospital in Singapore. All patients completed two self-administered HRQL questionnaires upon study entry, and their clinical information was retrieved from electronic medical records.
RESULTS
Ninety-nine patients (56% male, 75% Chinese) were included. The median (interquartile range) age was 63 (54-72) years. The most common ILD diagnosis was connective tissue disease-related ILD (n=51, 52%), followed by idiopathic pulmonary fibrosis (n=27, 27%). The mean (standard deviation) scores for the EQ5D-3L utility value, EQ5D Visual Analogue Scale (VAS) and K-BILD total were 0.806 (0.284), 75.1 (12.8) and 63.9 (14.3), respectively. A moderate correlation was found between the EQ5D-3L and K-BILD total and domain scores. The HRQL scores also correlate moderately with the modified Medical Research Council dyspnoea scale (mMRC) scores. There was a weak-to-moderate correlation between HRQL and forced vital capacity (FVC), carbon monoxide diffusing capacity (DLCO) and Charlson comorbidity index. Multiple linear regression showed a significant association of K-BILD total [beta coefficient 0.244, 95% confidence interval (CI): 0.075-0.414; P=0.005], K-BILD 'breathlessness and activities' (beta coefficient 0.448, 95% CI: 0.192-0.703; P=0.001), and the 'psychological' domain (beta coefficient 0.256, 95% CI: 0.024-0.488; P=0.031) with DLCO %pred after adjustment for age, sex, BMI, race, smoking history, comorbidities, FVC %pred and ILD diagnosis. Non-Chinese race was a predictor of better K-BILD 'psychological' domain (beta coefficient 8.680, 95% CI: 0.656-16.704; P=0.034) after adjustment.
CONCLUSIONS
HRQL is significantly impaired in ILD patients, and low DLCO is a strong predictor of this impairment.
背景
了解间质性肺疾病（ILD）患者的健康相关生活质量（HRQL）有助于洞察疾病负担以及治疗对患者幸福感的影响。我们使用国王简短ILD问卷（K-BILD）和欧洲五维度健康量表（EQ5D-3L）对一个多民族亚洲ILD队列的HRQL进行了研究，并探讨了其与多个临床变量的关联。
方法
这是一项在新加坡一家大学附属三级公立医院对ILD患者进行的单中心横断面研究。所有患者在研究入组时完成两份自我填写的HRQL问卷，并从电子病历中获取其临床信息。
结果
共纳入99例患者（56%为男性，75%为华裔）。年龄中位数（四分位间距）为63（54 - 72）岁。最常见的ILD诊断为结缔组织病相关ILD（n = 51，52%），其次是特发性肺纤维化（n = 27，27%）。EQ5D-3L效用值、EQ5D视觉模拟量表（VAS）和K-BILD总分的均值（标准差）分别为0.806（0.284）、75.1（12.8）和63.9（14.3）。发现EQ5D-3L与K-BILD总分及各领域得分之间存在中度相关性。HRQL得分与改良医学研究理事会呼吸困难量表（mMRC）得分也呈中度相关。HRQL与用力肺活量（FVC）、一氧化碳弥散量（DLCO）和查尔森合并症指数之间存在弱至中度相关性。多元线性回归显示，在调整年龄、性别、体重指数、种族、吸烟史、合并症、FVC预计值百分比和ILD诊断后，K-BILD总分[β系数0.244，95%置信区间（CI）：0.075 - 0.414；P = 0.005]以及K-BILD“呼吸急促与活动”领域（β系数0.448，95% CI：0.192 - 0.703；P = 0.001）和“心理”领域（β系数0.256，95% CI：0.024 - 0.488；P = 0.031）与DLCO预计值百分比存在显著关联。调整后，非华裔种族是K-BILD“心理”领域得分较高的预测因素（β系数8.680，95% CI：0.656 - 16.704；P = 0.034）。
结论
ILD患者的HRQL显著受损，低DLCO是这种损害的有力预测因素。
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