Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.
Neuropsychiatric Epidemiology Research Unit, School of Population and Global Health, The University of Western Australia, Crawley, WA, Australia.
J Gen Intern Med. 2023 Nov;38(15):3389-3405. doi: 10.1007/s11606-023-08380-4. Epub 2023 Aug 31.
Health-related quality of life (HRQoL) can be assessed through measures that can be generic or disease specific, encompass several independent scales, or employ holistic assessment (i.e., the derivation of composite scores). HRQoL measures may identify patients with differential risk profiles. However, the usefulness of generic and holistic HRQoL measures in identifying patients at higher risk of death is unclear. The aim of the present study was to undertake a scoping review of generic, holistic assessments of HRQoL as predictors of mortality in general non-patient populations and clinical sub-populations with specified conditions or risk factors in persons 18 years or older. Five databases were searched from 18 June to 29 June 2020 to identify peer-reviewed published articles. The searches were updated in August 2022. Reference lists of included and cited articles were also searched. Of 2552 articles screened, 110 met criteria for inclusion. Over one-third of studies were from North America. Most studies pertained to sub-populations with specified conditions and/or risk factors, almost a quarter for people with cardiovascular diseases. There were no studies pertaining to people with mental health conditions. Nearly three-quarters of the studies used a RAND Corporation QoL instrument, predominantly the SF-36, and nearly a quarter, a utility instrument, predominantly the EQ-5D. HRQoL was associated with mortality in 67 of 72 univariate analyses (92%) and 100 of 109 multivariate analyses (92%). HRQoL was found to be associated with mortality in the general population and clinical sub-populations with physical health conditions. Whether this relationship holds in people with mental health conditions is not known. HRQoL assessment may be useful for screening and/or monitoring purposes to understand how people perceive their health and well-being and as an indicator of mortality risk, encouraging better-quality and timely patient care to support and maximize what may be a patient's only modifiable outcome.
健康相关生命质量（HRQoL）可以通过通用或特定于疾病的测量方法来评估，这些方法可以涵盖多个独立的量表，或者采用整体评估（即，综合得分的推导）。HRQoL 测量方法可以识别具有不同风险特征的患者。然而，通用和整体 HRQoL 测量方法在识别死亡风险较高的患者方面的有用性尚不清楚。本研究旨在对通用和整体 HRQoL 评估作为 18 岁及以上一般非患者人群和具有特定疾病或风险因素的临床亚人群的死亡率预测因子进行范围综述。从 2020 年 6 月 18 日至 6 月 29 日，我们在五个数据库中搜索了同行评审的已发表文章。2022 年 8 月对搜索进行了更新。还对纳入和引用文章的参考文献进行了搜索。在筛选出的 2552 篇文章中，有 110 篇符合纳入标准。超过三分之一的研究来自北美。大多数研究涉及具有特定疾病和/或风险因素的亚人群，几乎四分之一的研究涉及心血管疾病患者。没有涉及心理健康状况患者的研究。近四分之三的研究使用了 RAND 公司的 QoL 工具，主要是 SF-36，近四分之一的研究使用了效用工具，主要是 EQ-5D。HRQoL 在 72 项单变量分析中的 67 项（92%）和 109 项多变量分析中的 100 项（92%）中与死亡率相关。在一般人群和具有身体健康状况的临床亚人群中，HRQoL 与死亡率相关。在心理健康状况患者中，这种关系是否存在尚不清楚。HRQoL 评估可能有助于筛选和/或监测目的，以了解人们如何感知自己的健康和幸福，并作为死亡率风险的指标，鼓励更好的、及时的患者护理，以支持和最大化患者唯一可改变的结果。
