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Abstract
Health Care Sciences & Services Health Policy & Services Life Sciences & Biomedicine Science & Technology
Background: Health-related quality of life (HRQOL) is a patient-centered outcome measure used in assessing the individual's overall functional health status but studies looking at HRQOL as a predictive tool are few. This work examines whether summary scores of HRQOL are predictive of all-cause hospitalization in the US Military HIV Natural History Study (NHS) cohort.
Methods: The Short Form 36 (SF-36) was administered between 2006 and 2010 to 1711 NHS cohort members whose hospitalization records we had also obtained. Physical component summary scores (PCSS) and mental component summary scores (MCSS) were computed based on standard algorithms. Terciles of PCSS and MCSS were generated with the upper terciles (higher HRQOL) as referent groups. Proportional hazards multivariate regression models were used to estimate the hazard of hospitalization for PCSS and MCSS separately (models 1 and 2, respectively) and combined (model 3).
Results: The hazard ratios (HR) of hospitalization were respectively 2.12 times (95% CI: 1.59-2.84) and 1.59 times (95% CI: 1.19-2.14) higher for the lower and middle terciles compared to the upper PCSS tercile. The HR of hospitalization was 133 times (95% CI: 1.02-1.73) higher for the lower compared to the upper MCSS tercile. Other predictors of hospitalization were CD4 count < 200 cells/mm(3) (HR = 2.84, 95% CI: 1.96, 4.12), CD4 count 200-349 cells/mm 3 (HR = 1.67, 95% CI: 1.24, 2.26), CD4 count 350-499 cells/mm(3) (HR =1.41, 95% CI: 1.09, 1.83), plasma viral load > 50 copies/mL (HR = 1.82, 95% CI: 1.46, 2.26), and yearly increment in duration of HIV infection (HR = 0.94, 95% CI: 0.93, 0.96) (model 3).
Conclusion: After controlling for factors associated with hospitalization among those with HIV, both PCSS and MCSS were predictive of all-cause hospitalization in the NHS cohort. HRQOL assessment using the SF-36 may be useful in stratifying hospitalization risk among HIV-infected populations.
Lower health-related quality of life predicts all-cause hospitalization among HIV-infected individuals
Creators
Leonard Emuren - Children's Hospital of The King's Daughters
Seth Welles - Drexel University
Marcia Polansky - Drexel University
Alison A. Evans - Drexel University
Grace Macalino - Henry M. Jackson Foundation
Brian K. Agan - Henry M. Jackson Foundation
Infectious Dis Clinical Res
Publication Details
Health and quality of life outcomes, v 16(1), pp 107-107
Publisher
Springer Nature
Number of pages
11
Grant note
Y1-AI-5072 / National Institute of Allergy and Infectious Diseases, National Institutes of Health (NIH); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Allergy & Infectious Diseases (NIAID)
Resource Type
Journal article
Language
English
Academic Unit
[Retired Faculty]; Epidemiology and Biostatistics
Web of Science ID
WOS:000434058200002
Scopus ID
2-s2.0-85047936817
Other Identifier
991019167817404721
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