SF-36 summary and subscale scores are reliable outcomes of neuropsychiatric events in systemic lupus erythematosus

被引:45
作者
Hanly, J. G. [1 ,2 ,3 ]
Urowitz, M. B. [4 ,5 ]
Jackson, D. [6 ]
Bae, S. C. [7 ]
Gordon, C. [8 ]
Wallace, D. J. [9 ]
Clarke, A. [10 ,11 ]
Bernatsky, S. [11 ,12 ]
Vasudevan, A. [13 ]
Isenberg, D.
Rahman, A. [14 ]
Sanchez-Guerrero, J. [15 ]
Romero-Diaz, J. [15 ]
Merrill, J. T. [16 ]
Fortin, P. R. [4 ,5 ]
Gladman, D. D. [4 ,5 ]
Bruce, I. N. [17 ]
Steinsson, K. [18 ]
Khamashta, M. [19 ]
Alarcon, G. S. [20 ]
Fessler, B. [20 ]
Petri, M. [21 ]
Manzi, S. [22 ]
Nived, O. [23 ]
Sturfelt, G. [23 ]
Ramsey-Goldman, R. [24 ,25 ]
Dooley, M. A. [26 ]
Aranow, C. [27 ]
Van Vollenhoven, R. [28 ]
Ramos-Casals, M. [29 ,30 ]
Zoma, A. [31 ]
Kalunian, K. [29 ]
Farewell, V. [6 ]
机构
[1] Queen Elizabeth 2 Hlth Sci Ctr, Div Rheumatol, Dept Med, Halifax, NS, Canada
[2] Queen Elizabeth 2 Hlth Sci Ctr, Div Rheumatol, Dept Pathol, Halifax, NS, Canada
[3] Dalhousie Univ, Halifax, NS, Canada
[4] Toronto Western Hosp, Ctr Prognosis Studies Rheumat Dis, Toronto, ON M5T 2S8, Canada
[5] Univ Toronto, Toronto, ON M5S 1A1, Canada
[6] Univ Forvie Site, Inst Publ Hlth, MRC, Biostat Unit, Cambridge, England
[7] Hanyang Univ Hosp Rheumat Dis, Dept Rheumatol, Seoul, South Korea
[8] Univ Birmingham, Coll Med & Dent Sci, Sch Immun & Infect, Rheumatol Res Grp, Birmingham, W Midlands, England
[9] Univ Calif Los Angeles, Cedars Sinai David Geffen Sch Med, Los Angeles, CA USA
[10] McGill Univ, Montreal Gen Hosp, Ctr Hlth, Div Clin Immunol Allergy, Montreal, PQ H3G 1A4, Canada
[11] McGill Univ, Montreal Gen Hosp, Ctr Hlth, Div Clin Epidemiol, Montreal, PQ H3G 1A4, Canada
[12] McGill Univ, Montreal Gen Hosp, Ctr Hlth, Div Rheumatol, Montreal, PQ H3G 1A4, Canada
[13] Suny Downstate Med Ctr, Dept Med, Brooklyn, NY 11203 USA
[14] UCL, Ctr Rheumatol Res, London, England
[15] Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Mexico City, DF, Mexico
[16] Oklahoma Med Res Fdn, Dept Clin Pharmacol, Oklahoma City, OK 73104 USA
[17] Univ Manchester, Manchester Acad Hlth Sci Ctr, Sch Translat Med, Arthrit Res UK Epidemiol Unit, Manchester, Lancs, England
[18] Landspitali Univ Hosp, Ctr Rheumatol Res, Reykjavik, Iceland
[19] Kings Coll London, Sch Med, St Thomas Hosp, Rayne Inst,Lupus Res Unit, London WC2R 2LS, England
[20] Univ Alabama, Dept Med, Birmingham, AL 35294 USA
[21] Johns Hopkins Univ, Dept Rheumatol, Baltimore, MD USA
[22] Univ Pittsburgh, Sch Med, Div Rheumatol, Pittsburgh, PA USA
[23] Univ Lund Hosp, Dept Rheumatol, S-22185 Lund, Sweden
[24] Northwestern Univ, Chicago, IL 60611 USA
[25] Feinberg Sch Med, Chicago, IL USA
[26] Univ N Carolina, Chapel Hill, NC USA
[27] Columbia Univ, Med Ctr, New York, NY USA
[28] Karolinska Inst, Dept Rheumatol, Stockholm, Sweden
[29] UCSD Sch Med, La Jolla, CA USA
[30] Serv Enfermedades Autoinmunes Hosp Clin & Prov, Barcelona, Spain
[31] Hairmyres Hosp, Lanarkshire Ctr Rheumatol, E Kilbride, Lanark, Scotland
基金
加拿大健康研究院; 英国惠康基金; 美国国家卫生研究院; 英国医学研究理事会;
关键词
QUALITY-OF-LIFE; INTERNATIONAL INCEPTION COHORT; CENTRAL-NERVOUS-SYSTEM; INTRAVENOUS CYCLOPHOSPHAMIDE; PREVALENCE; INDEX; CORTICOSTEROIDS; MANIFESTATIONS; VALIDATION; DIAGNOSIS;
D O I
10.1136/ard.2010.138792
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective To examine change in health-related quality of life in association with clinical outcomes of neuropsychiatric events in systemic lupus erythematosus (SLE). Methods An international study evaluated newly diagnosed SLE patients for neuropsychiatric events attributed to SLE and non-SLE causes. The outcome of events was determined by a physician-completed seven-point scale and compared with patient-completed Short Form 36 (SF-36) health survey questionnaires. Statistical analysis used linear mixed-effects regression models with patient-specific random effects. Results 274 patients (92% female; 68% Caucasian), from a cohort of 1400, had one or more neuropsychiatric event in which the interval between assessments was 12.3+/-2 months. The overall difference in change between visits in mental component summary (MCS) scores of the SF-36 was significant (p<0.0001) following adjustments for gender, ethnicity, centre and previous score. A consistent improvement in neuropsychiatric status (N=295) was associated with an increase in the mean (SD) adjusted MCS score of 3.66 (0.89) in SF-36 scores. Between paired visits when the neuropsychiatric status consistently deteriorated (N=30), the adjusted MCS score decreased by 4.00 (1.96). For the physical component summary scores the corresponding changes were + 1.73 (0.71) and -0.62 (1.58) (p<0.05), respectively. Changes in SF-36 subscales were in the same direction (p<0.05; with the exception of role physical). Sensitivity analyses confirmed these findings. Adjustment for age, education, medications, SLE disease activity, organ damage, disease duration, attribution and characteristics of neuropsychiatric events did not substantially alter the results. Conclusion Changes in SF-36 summary and subscale scores, in particular those related to mental health, are strongly associated with the clinical outcome of neuropsychiatric events in SLE patients.
引用
收藏
页码:961 / 967
页数:7
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