Vijiaratnam Nirosen, Vadera Shree, Lefringhausen Katharina, Girges Christine, Schrag Anette
Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK.
Department of Medicine, Royal Free Hampstead NHS Trust, London, UK.
BMJ Neurol Open. 2023 Aug 30;5(2):e000464. doi: 10.1136/bmjno-2023-000464. eCollection 2023.
Several tools exist to assess comorbidities in neurological disorders, the most widely used being the Charlson Comorbidity Index (CCI), but it has several limitations. The Comorbidity and General Health Questionnaire (CGHQ) is a newly designed tool, which includes additional comorbidities associated with health-related quality of life (HR-QOL) and outcomes in neurological disorders.
To assess the feasibility and validity of the CGHQ in patients with neurological disease.
Two hundred patients attending a general neurological clinic were invited to complete the CGHQ along with the EQ-5D-5L questionnaire. The CCI was simultaneously completed by the assessor. CGHQ comorbidity scores were compared with CCI, symptom burden and EQ-5D-5L scores.
The CGHQ captured 22 additional comorbidities not included on the CCI and more comorbidities were endorsed on the CGHQ. The CGHQ correlated weakly to moderately with CCI comorbidity scores. While both the CGHQ and CCI correlated negatively with the EQ-5D-5L Visual Analogue Scale, only the CGHQ correlated negatively with the EQ-5D-5L summary index. The CGHQ but not the CCI correlated strongly and positively with symptom burden scores.
The CGHQ allows a more comprehensive assessment of comorbidities than the CCI and better correlates with patients' overall symptom burden and HR-QOL in neurological patients.
有多种工具可用于评估神经系统疾病中的合并症,其中使用最广泛的是查尔森合并症指数(CCI),但它有一些局限性。合并症与总体健康问卷(CGHQ)是一种新设计的工具,它纳入了与健康相关生活质量(HR-QOL)及神经系统疾病预后相关的其他合并症。
评估CGHQ在神经系统疾病患者中的可行性和有效性。
邀请200名到普通神经科门诊就诊的患者同时完成CGHQ和EQ-5D-5L问卷。评估者同时完成CCI。将CGHQ合并症得分与CCI、症状负担及EQ-5D-5L得分进行比较。
CGHQ涵盖了CCI未包括的另外22种合并症,且CGHQ上认可的合并症更多。CGHQ与CCI合并症得分的相关性为弱到中度。虽然CGHQ和CCI与EQ-5D-5L视觉模拟量表均呈负相关,但只有CGHQ与EQ-5D-5L汇总指数呈负相关。CGHQ与症状负担得分呈强正相关,而CCI则不然。
与CCI相比,CGHQ能对合并症进行更全面的评估,并且与神经科患者的总体症状负担和HR-QOL的相关性更好。