The characterisation and determinants of quality of life in ANCA associated vasculitis
The characterisation and determinants of quality of life in ANCA associated vasculitis
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DOI：
10.1136/annrheumdis-2012-202750
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发表时间：
2014-01-01
影响因子：
27.4
通讯作者：
Macfarlane, Gary J.
中科院分区：
文献类型：
--
作者：
Basu, Neil;McClean, Andrew;Macfarlane, Gary J.
目的探讨抗神经细胞胞浆抗体（ANCA）相关性血管炎（AAV）患者健康相关生活质量（QOL）的影响因素。收集身体和精神生活质量的措施，以及假定的生活质量损害的生物心理社会决定因素。同时，记录假定的临床QOL决定因素。条件Logistic回归分析的特点是组间差异，而多变量Logistic回归分析确定了病例内QOL相关性，并使用人群归因风险（PAR）进一步量化。（身体QOL：OR 0.7，95% CI 0.4 - 1.1;精神QOL：OR 1.1，95% CI 0.8 - 1.6）。然而，与一般人群对照相比，他们更有可能报告较差的QOL（n = 470）（身体QOL：OR 7.0，95% CI 4.4 - 11.1;精神QOL：OR 2.5，95% CI 1.7 - 3.6）。少数临床因素，但更多的生物心理社会因素与生活质量差独立相关。在人口方面，疲劳被认为是主要的重要性（身体生活质量：PAR 24.6%;精神生活质量：PAR 47.4%）。结论AAV患者经历了显着的生活质量损害相比，一般人群，但类似于那些与其他慢性疾病的相当大的需求已经得到承认。已经确定了潜在的可改变的临床决定因素;然而，生物心理社会干预可能会在该患者人群中提供更大的生活质量增益。
Objectives To contextualise and identify the determinants of poor health related quality of life (QOL) among patients with antineutrophil cytoplasm antibody (ANCA) associated vasculitis (AAV).Methods A multicentre AAV case-control study was conducted using two matched groups of population and chronic disease controls. Measures of physical and mental QOL as well as putative bio-psychosocial determinants of QOL impairment were collected. Concurrently, putative clinical QOL determinants were recorded. Conditional logistic regression analyses characterised group differences while multivariable logistic regression identified within-case QOL associations which were further quantified using population attributable risks (PAR).Results Cases (n=410) experienced similar QOL to chronic disease controls (n=318) (physical QOL: OR 0.7, 95% CI 0.4 to 1.1; mental QOL: OR 1.1, 95% CI 0.8 to 1.6). However, they were substantially more likely to report poor QOL compared to general population controls (n=470) (physical QOL: OR 7.0, 95% CI 4.4 to 11.1; mental QOL: OR 2.5, 95% CI 1.7 to 3.6). A few clinical, but many more bio-psychosocial factors were independently associated with poor QOL. In population terms, fatigue was found to be of principal importance (physical QOL: PAR 24.6%; mental QOL: PAR 47.4%).Conclusions AAV patients experienced significant QOL impairment compared to the general population, but similar to those with other chronic diseases whose considerable needs are already recognised. Potentially modifiable clinical determinants have been identified; however bio-psychosocial interventions are likely to provide the greater QOL gains in this patient population.