Association among SF36 quality of life measures and nutrition, hospitalization, and mortality in hemodialysis
Association among SF36 quality of life measures and nutrition, hospitalization, and mortality in hemodialysis
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DOI：
10.1681/asn.v12122797
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发表时间：
2001-12-01
影响因子：
13.6
通讯作者：
Humphreys, MH
中科院分区：
文献类型：
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作者：
Kalantar-Zadeh, K;Kopple, JD;Humphreys, MH
维持性血液透析（MHD）患者的生活质量（QoL）经常大幅下降。SF 36（包含36个问题的简表）是一种记录良好的自我管理的QoL评分系统，包括8个独立量表和2个主要维度，已被广泛使用和验证。在65例接受MHD的成人门诊患者中，评估了SF 36及其量表和维度（评分为0 - 100之间的数字），以及通过主观全面评估、近红外（NIR）体脂、体重指数（BMI）和相关实验室值（包括血红蛋白、白蛋白和C反应蛋白）测量的营养和炎症状态。10个月的前瞻性住院率和死亡率被用作临床结局。多变量（病例组合）调整的相关系数在SF 36评分与血清白蛋白和血红蛋白浓度之间具有统计学显著性。SF 36评分与BMI、NIR体脂百分比呈显著负相关。接受MHD治疗的低白蛋白血症、贫血和肥胖患者的生活质量较差。前瞻性住院与SF 36总分及其两个主要维度显著相关（r在-0.28和-0.40之间）。SF 36每降低10个单位，死亡的考克斯比例回归相对风险为2.07（95% CI，1.08 - 3.98; P = 0.02）。在SF 36的八个组成部分和两个维度中，心理健康维度和SF 36总分对死亡率的预测价值最强。因此，在接受MHD的患者中，SF 36似乎与营养状况、贫血和临床结局（包括预期住院和死亡率）的测量值有显著相关性。尽管肥胖与营养不良不同，通常不是MHD预后不良的指标，但SF 36可检测出MHD肥胖患者的发病率和死亡率风险较高。
Patients on maintenance hemodialysis (MHD) often show substantial reductions in quality of life (QoL). The SF36 (Short Form with 36 questions), a well-documented, self-administered QoL scoring system that includes eight independent scales and two main dimensions, has been widely used and validated. In 65 adult outpatients on MHD, the SF36 and its scales and dimensions, scored as a number between 0 and 100, and the nutritional and inflammatory state measured by subjective global assessment, near-infrared (NIR) body fat, body mass index (BMI), and pertinent laboratory values, including hemoglobin, albumin, and C-reactive protein were assessed. Twelve-month prospective hospitalization rates and mortality were used as the clinical outcomes. Multivariate (case-mix) adjusted correlation coefficients were statistically significant between SF36 scores and serum albumin and hemoglobin concentrations. There were significant inverse correlations be-tween SF36 scores and the BMI and NIR body fat percentage. Hypoalbuminemic, anemic, and obese patients on MHD had a worse QoL. Prospective hospitalizations correlated significantly with the SF36 total score and its two main dimensions (r between -0.28 and -0.40). The Cox proportional regression relative risk of death for each 10 unit decrease in SF36 was 2.07 (95% CI, 1.08 to 3.98; P = 0.02). Of the eight components and two dimensions of the SF36, the Mental Health dimension and the SF36 total score had the strongest predictive value for mortality. Thus, in patients on MHD the SF36 appears to have significant associations with measures of nutritional status, anemia, and clinical outcomes, including prospective hospitalization and mortality. Even though obesity, unlike undernutrition, is not generally an indicator of poor outcome in MHD, the SF36 may detect obese patients on MHD at higher risk for morbidity and mortality.