Impact on health related quality of life of adult spinal deformity (ASD) compared with other chronic conditions
Impact on health related quality of life of adult spinal deformity (ASD) compared with other chronic conditions
复制标题
DOI：
10.1007/s00586-014-3542-1
复制
发表时间：
2015-01-01
影响因子：
2.8
通讯作者：
Acaroglu, Emre
中科院分区：
文献类型：
--
作者：
Pellise, Ferran;Vila-Casademunt, Alba;Acaroglu, Emre
医疗和卫生政策提供者应了解成人脊柱畸形（ASD）对健康相关生活质量（HRQL）的影响。这项研究的目的是比较四种慢性疾病与ASD的相对负担，国际生活质量评估项目收集了24,936人的数据，并公布了自我报告关节炎、慢性肺病、Alonso等（Qual Life Res Int J Qual Life Asp Treat Care Rehabil 13：283-298，2004）。我们将这些数据与一个前瞻性多中心国际数据库中入选的ASD患者的SF-36基线数据进行了比较，这些患者的入选标准如下：年龄> 18岁，脊柱侧凸> 20 A度，矢状面垂直轴> 5 cm，骨盆倾斜> 25 A度或胸椎后凸> 60 A度。考虑了四个ASD组：所有ASD患者、手术候选人（术前HRQL评分）和既往手术和未手术的非手术候选人。调整后的慢性疾病的影响估计值计算使用单独的多元线性回归模型。没有慢性疾病的个体被用作参考组。每种慢性疾病和ASD的系数代表与健康组相比的差异。766例患者（平均年龄45.8岁）符合ASD的入选标准。ASD患者所有SF-36领域的评分均低于任何其他慢性疾病。ASD和其他慢性疾病之间的差异总是大于报告的最小临床重要差异。与未报告任何医疗状况的个体相比，自报慢性疾病人群的SF-36评分范围为-2.5至-14.1。ASD患者的可比评分范围为-10.9至-45.0。躯体功能、躯体角色和疼痛领域得分最低。患有ASD的手术候选人显示出最差的HRQL评分（-17.4至-45.0），而先前手术的患者表现最好（-10.9至-33.3）;然而，即使后者仍然比其他自我报告的慢性疾病的任何评分都要差。ASD对HRQL的影响值得与其他重要慢性病一样的研究和卫生政策关注。
Medical and health policy providers should be aware of the impact of adult spinal deformity (ASD) on health-related quality of life (HRQL). The purpose of this study was to compare the relative burden of four chronic conditions with that of ASD.The International Quality of Life Assessment project gathered data from 24,936 people and published the SF-36 scores of patients with self-reported arthritis, chronic lung disease, diabetes and congestive heart failure from 8 industrialized countries (3 continents) Alonso et al. (Qual Life Res Int J Qual Life Asp Treat Care Rehabil 13:283-298, 2004). We compared these with the SF-36 baseline data of consecutive patients with ASD enrolled in a prospective multicentre international database with the following inclusion criteria: age > 18 years and scoliosis > 20A degrees, sagittal vertical axis > 5 cm, pelvic tilt > 25A degrees or thoracic kyphosis > 60A degrees. Four ASD groups were considered: all ASD patients, surgical candidates (preop HRQL scores), and non-surgical candidates with and without previous surgery. Adjusted estimates of the impact of chronic disease were calculated using separate multivariate linear regression models. Individuals without chronic conditions were used as the reference group. Coefficients for each chronic condition and ASD represent the difference compared with this healthy group.766 patients (mean age 45.8 years) met the inclusion criteria for ASD. The scores on all SF-36 domains were lower in ASD patients than in any other chronic condition. Differences between ASD and the other chronic conditions were always greater than the reported minimal clinically important differences. When compared with individuals reporting no medical conditions, SF-36 scores from the population with self-reported chronic conditions ranged from -2.5 to -14.1. Comparable scores for patients with ASD ranged from -10.9 to -45.0. Physical function, role physical and pain domains showed the worst scores. Surgical candidates with ASD displayed the worst HRQL scores (-17.4 to -45.0) and patients previously operated the best (-10.9 to -33.3); however, even the latter remained worse than any scores for the other self-reported chronic conditions.The global burden of ASD was huge compared with other self-reported chronic conditions in the general population of eight industrialized countries. The impact of ASD on HRQL warrants the same research and health policy attention as other important chronic diseases.