Wrotek August, Wrotek Oliwia, Jackowska Teresa
Department of Pediatrics, Centre of Postgraduate Medical Education, 99/103 Marymoncka Str., 01-813 Warsaw, Poland.
Department of Pediatrics, Bielanski Hospital, 80 Cegłowska Str., 01-809 Warsaw, Poland.
Diseases. 2023 Aug 30;11(3):111. doi: 10.3390/diseases11030111.
Respiratory syncytial virus (RSV) is one of the most frequent etiological factors of lower respiratory tract infections in children, potentially affecting patients' quality of life (QoL). We aimed to asses QoL in children under 2 years of age hospitalized due to laboratory-confirmed RSV infection.
A QoL was assessed by parents/tutors with the use of the 100-point visual analog scale and compared against a disease-free period. We evaluated the median utility, QoL loss (reported in days), and quality-adjusted life years (QALY) loss in relation to RSV hospitalization.
We included 132 patients aged from 17 days to 24 months (median 3.8 months). The mean utility during the hospitalization varied between 0.418 and 0.952, with a median of 0.679 (95%CI: 0.6-0.757) and median loss of 0.321 [0.243-0.4], which further translated into a loss of 2.2 days (95%CI: 1.6-3.1). The QALY loss varied between 0.526 × 10 and 24.658 × 10, with a median of 6.03 × 10 (95%CI: 4.38-8.48 × 10). Based upon the final diagnoses, the highest QALY loss was 6.99 × 10 (95%CI: 5.29-13.7 × 10) for pneumonia, followed by bronchiolitis-5.96 × 10 (4.25-8.41 × 10) and bronchitis-4.92 × 10 (2.93-6.03 × 10); significant differences were observed only between bronchitis and pneumonia ( = 0.0171); the QALY loss was not age-dependent. Although an increasing tendency in the utility score was observed, a strong cumulative effect related to the length of stay was noted until day 13.
RSV contributes significantly to the utility deterioration and QALY loss in the case of RSV hospitalization, and the patient-reported data should be used in pharmacoeconomic assessments of the impact of RSV.
呼吸道合胞病毒（RSV）是儿童下呼吸道感染最常见的病因之一，可能影响患者的生活质量（QoL）。我们旨在评估因实验室确诊的RSV感染而住院的2岁以下儿童的生活质量。
由父母/监护人使用100分视觉模拟量表评估生活质量，并与无病期进行比较。我们评估了与RSV住院相关的中位效用、生活质量损失（以天数报告）和质量调整生命年（QALY）损失。
我们纳入了132例年龄在17天至24个月（中位年龄3.8个月）的患者。住院期间的平均效用在0.418至0.952之间，中位数为0.679（95%CI：0.6-0.757），中位损失为0.321[0.243-0.4]，这进一步转化为2.2天的损失（95%CI：1.6-3.1）。QALY损失在0.526×10至24.658×10之间，中位数为6.03×10（95%CI：4.38-8.48×10）。根据最终诊断，肺炎的最高QALY损失为6.99×10（95%CI：5.29-13.7×10），其次是细支气管炎-5.96×10（4.25-8.41×10）和支气管炎-4.92×10（2.93-6.03×10）；仅在支气管炎和肺炎之间观察到显著差异（=0.0171）；QALY损失与年龄无关。尽管观察到效用评分有上升趋势，但直到第13天，都注意到与住院时间相关的强烈累积效应。
在RSV住院的情况下，RSV对效用恶化和QALY损失有显著影响，患者报告的数据应用于RSV影响的药物经济学评估。
