Natalia Smirnova, Jane Lowers, Matthew J Magee, Sara C Auld, William R Hunt, Anne Fitzpatrick, Vibha Lama, Dio Kavalieratos
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引用次数: 0
Abstract
Purpose: People living with cystic fibrosis (CF) experience impaired quality of life, but the extent to which pulmonary function is associated with quality of life in CF remains unclear METHODS: Using baseline data from a trial of specialist palliative care in adults with CF, we examined the association between pulmonary obstruction and quality of life (measured with the Functional Assessment of Chronic Illness Therapy Total Score).
Results: Among 262 participants, median age was 33, and 78% were on modulator therapy. The median quality of life score was higher in those with mild obstruction (135, IQR 110-156) compared to moderate (125, IQR 109-146) and severe obstruction (120, IQR 106-136). In an unadjusted model, we observed a non-significant trend toward lower quality of life with increased obstruction-compared to participants with mild obstruction, those with moderate obstruction had quality of life score 7.46 points lower (95% CI -15.03 to 0.10) and those with severe obstruction had a score 9.98 points lower (95% CI -21.76 to 1.80). However, this association was no longer statistically significant in the adjusted model, which may reflect confounding due to sex, age, BMI, and modulator therapy. Comorbidities (depression and anxiety) and social determinants of health (financial insecurity and education) were also associated with quality of life.
Conclusion: Advancing our understanding of patient-centered markers of quality of life, rather than focusing on pulmonary function alone, may help identify novel interventions to improve quality of life in this patient population.
目的:囊性纤维化(CF)患者的生活质量受损,但肺功能与CF患者生活质量的关联程度尚不清楚。方法:使用CF成人专科姑息治疗试验的基线数据,我们检查了肺阻塞与生活质量之间的关系(用慢性疾病治疗功能评估总分测量)。结果:262名参与者中位年龄为33岁,78%接受了调节剂治疗。轻度梗阻(135,IQR 110-156)患者的中位生活质量评分高于中度梗阻(125,IQR 109-146)和重度梗阻(120,IQR 106-136)患者。在未调整的模型中,我们观察到梗阻增加导致生活质量降低的非显著趋势——与轻度梗阻相比,中度梗阻患者的生活质量得分低7.46分(95% CI -15.03至0.10),严重梗阻患者的生活质量得分低9.98分(95% CI -21.76至1.80)。然而,这种关联在调整后的模型中不再具有统计学意义,这可能反映了由于性别、年龄、BMI和调节剂治疗引起的混淆。合并症(抑郁和焦虑)和健康的社会决定因素(经济不安全和教育)也与生活质量有关。结论:提高我们对以患者为中心的生活质量指标的理解,而不是仅仅关注肺功能,可能有助于确定新的干预措施来改善这类患者的生活质量。
期刊介绍:
Lung publishes original articles, reviews and editorials on all aspects of the healthy and diseased lungs, of the airways, and of breathing. Epidemiological, clinical, pathophysiological, biochemical, and pharmacological studies fall within the scope of the journal. Case reports, short communications and technical notes can be accepted if they are of particular interest.