Low health-related quality of life is associated with all-cause mortality in patients with diabetes on haemodialysis: the Japan Dialysis Outcomes and Practice Pattern Study
Low health-related quality of life is associated with all-cause mortality in patients with diabetes on haemodialysis: the Japan Dialysis Outcomes and Practice Pattern Study
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DOI：
10.1111/j.1464-5491.2009.02800.x
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发表时间：
2009-09-01
影响因子：
3.5
通讯作者：
Kurokawa, K.
中科院分区：
文献类型：
--
作者：
Hayashino, Y.;Fukuhara, S.;Kurokawa, K.
目的 对于因糖尿病并发症而导致 HRQoL 极低的患者，是否可以准确预测与健康相关的生活质量 (HRQoL) 尚不清楚。我们调查了 HRQoL 对接受血液透析的糖尿病患者死亡风险的影响。方法对随机选择的在日本接受血液透析的患者进行透析结果实践模式研究 (DOPPS) 的数据进行分析。从基线病历中提取有关糖尿病诊断和随访期间临床事件的信息，并通过自我报告的简短表格 (SF)-36 问卷评估 HRQoL。使用Cox比例风险模型分析SF-36中身体成分评分和精神成分评分与死亡风险之间的关联。结果分析了527名接受血液透析的糖尿病患者的数据。身体成分评分大于或等于中位数的年龄调整死亡风险比为 0.27 [95% 置信区间 (CI) 0.08-0.96]，精神成分评分大于或等于中位数的多变量调整死亡风险比为 1.21 (95% CI 0.44-3.35)。 结论 SF-36 得出的身体成分评分是死亡的独立危险因素。接受血液透析的糖尿病患者的 HRQoL 评分通常非常低。基线心理成分评分不能预测死亡率。患者自我报告健康状况的身体部分可能有助于糖尿病患者进行血液透析的风险分层和临床决策。
AimsWhether health-related quality of life (HRQoL) can be accurately predicted in patients with extremely low HRQoL as a result of diabetic complications is unclear. We investigated the impact of HRQoL on mortality risk in patients with diabetes on haemodialysis.MethodsData from the Dialysis Outcomes Practice Pattern Study (DOPPS) were analysed for randomly selected patients receiving haemodialysis in Japan. Information regarding the diagnosis of diabetes and clinical events during follow-up was abstracted from the medical records at baseline and HRQoL was assessed by a self-reported short form (SF)-36 questionnaire. The association between physical component score and mental component score in the SF-36 and mortality risk was analysed using a Cox proportional hazard model.ResultsData from 527 patients with diabetes on haemodialysis were analysed. The mortality age-adjusted hazard ratio of having a physical component score greater than or equal to the median was 0.27 [95% confidence interval (CI) 0.08-0.96] and the multivariable-adjusted mortality hazard ratio of having an mental component score greater than or equal to the median was 1.21 (95% CI 0.44-3.35).ConclusionsThe physical component score derived from the SF-36 is an independent risk factor for mortality in patients with diabetes on haemodialysis who generally had very low HRQoL scores. Baseline mental component score was not predictive of mortality. Patient self-reporting regarding the physical component of health status may aid in risk stratification and clinical decision making for patients with diabetes on haemodialysis.