Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Qual Life Res. 2023 Jul;32(7):1871-1881. doi: 10.1007/s11136-023-03357-6. Epub 2023 Feb 9.
Adults with dysvascular lower extremity amputation (LEA) experience a large number of secondary health conditions yet there is a gap in the literature on health utility scores for this population. A health utility score relates to a person's state of well-being, and is a single metric anchored at 0 (death) and 1 (perfect health). This study aimed to provide a descriptive account of health utility scores in community-dwelling adults with dysvascular LEA.
Participants were adults with dysvascular LEA who were 3 months post-amputation. Data collected included socio-demographic characteristics, the Special Interest Group in Amputee Medicine (SIGAM) grades, the dysvascular conditions scale (DCS), which is a scale developed for this study, and the Short Form-36 (SF-36). SF-6D health utility scores were derived from the SF-36 using a software algorithm. Participants were grouped into low-impact and high-impact groups based on self-reported severity of symptoms using the DCS. Health utility scores were compared between the low-impact and high-impact groups using independent t-tests.
A total of 231 participants were enrolled in the study. The mean SF-6D health utility score was 0.689 (0.127). A significant association was found between health utility score and SIGAM grade (p < 0.001, η2 = .09). Health utility was positively associated with age (r = 0.137, p = 0.037) and months post-amputation (r = 0.141, p = 0.032), and negatively associated with DCS severity (r = -0.526, p < 0.001). Health utility scores were lower for participants in the DCS high-impact groups for conditions such as diabetes mellitus, phantom limb pain, musculoskeletal pain, back pain, psychological distress, depression, vision problems, and other pain.
Cost-utility analyses rely on health utility estimates and our findings provide data for future economic evaluations that may assist policy makers in evidence informed allocation of healthcare resources for this population.
患有血管性下肢截肢（LEA）的成年人会经历大量的继发性健康状况，但关于该人群健康效用评分的文献存在空白。健康效用评分与一个人的健康状况有关，是一个以 0（死亡）和 1（完全健康）为锚点的单一指标。本研究旨在提供社区居住的血管性 LEA 成年人健康效用评分的描述性说明。
参与者为血管性 LEA 截肢后 3 个月的成年人。收集的数据包括社会人口统计学特征、截肢医学特别兴趣小组（SIGAM）分级、专为这项研究开发的血管性疾病量表（DCS）以及简短形式 36 项健康调查（SF-36）。使用软件算法从 SF-36 中得出 SF-6D 健康效用评分。根据 DCS 报告的症状严重程度，参与者被分为低影响组和高影响组。使用独立 t 检验比较低影响组和高影响组之间的健康效用评分。
共有 231 名参与者入组本研究。SF-6D 健康效用评分的平均值为 0.689（0.127）。健康效用评分与 SIGAM 分级之间存在显著关联（p<0.001，η2=0.09）。健康效用与年龄呈正相关（r=0.137，p=0.037）和截肢后月数呈正相关（r=0.141，p=0.032），与 DCS 严重程度呈负相关（r=-0.526，p<0.001）。在 DCS 高影响组中，参与者的糖尿病、幻肢痛、肌肉骨骼疼痛、背痛、心理困扰、抑郁、视力问题和其他疼痛等疾病的健康效用评分较低。
成本效用分析依赖于健康效用估计，我们的研究结果为未来的经济评估提供了数据，这可能有助于决策者为该人群的医疗资源分配提供循证依据。
