EuroQol (EQ-5D) measure of quality of life predicts mortality, emergency department utilization, and hospital discharge
- PDF / 525,675 Bytes
- 9 Pages / 610 x 792 pts Page_size
- 78 Downloads / 188 Views
Open Access
Research
EuroQol (EQ-5D) measure of quality of life predicts mortality, emergency department utilization, and hospital discharge rates in HIV-infected adults under care William C Mathews*1 and Susanne May2 Address: 1Department of Medicine, University of California San Diego, San Diego, CA, USA and 2Division of Biostatistics and Bioinformatics, Department of Family and Preventive Medicine and Department of Neurosciences, University of California San Diego, La Jolla, CA, USA Email: William C Mathews* - [email protected]; Susanne May - [email protected] * Corresponding author
Published: 25 January 2007 Health and Quality of Life Outcomes 2007, 5:5
doi:10.1186/1477-7525-5-5
Received: 7 November 2006 Accepted: 25 January 2007
This article is available from: http://www.hqlo.com/content/5/1/5 © 2007 Mathews and May; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Health-related quality of life (HR-QOL) is a relevant and quantifiable outcome of care. We implemented HR-QOL assessment at all primary care visits at UCSD Owen Clinic using EQ-5D. The study aim was to estimate the prognostic value of EQ-5D for survival, hospitalization, and emergency department (ED) utilization after controlling for CD4 and HIV plasma viral load (pVL). Methods: We conducted a retrospective analysis of HIV clinic based cohort (1996–2000). The EQ-5D includes single item measures of: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each item is coded using 3-levels (1 = no problems; 2 = some problems; 3 = severe problems). The instrument includes a global rating of current health using a visual analog scale (VAS) ranging from 0 (worst imaginable) to 100 (best imaginable). An additional single item measure of health change (better, much the same, worse) was included. A predicted VAS (pVAS) was estimated by regressing the 5 EQ-5D health states on VAS using reference cell coding of health states and random effects linear models. Survival models were fit using Cox modelling. Hospitalization and ED rate models were estimated using population-averaged Poisson models. Results: 965 patients met eligibility criteria. 12% were female; 42% were non-white. Median timeat-risk was 1.2 years. Median CD4 was 233. Median log10(pVL) was 4.6. 47 deaths occurred. In two Cox models controlling for CD4 and pVL, the adjusted hazard ratios (aHR) for VAS and pVAS as time-varying covariates were 0.73 (95% CI: 0.63–0.83) and 0.66 (95% CI: 0.56–0.77) respectively, for every 10 point increase in (p)VAS rating. In Poisson regression models predicting ED visit rates and hospital discharge rates controlling for current CD4 and pVL, each of the EQ-5D health dimensions, VAS, and health change items were significantly (p < 0.05) associated with the outcomes. For ED vi
Data Loading...
