Literature DB >> 15192614

The impact of treatment of pulmonary exacerbations on the health-related quality of life of patients with cystic fibrosis: does hospitalization make a difference?

Michael S Yi1, Joel Tsevat, Robert W Wilmott, Uma R Kotagal, Maria T Britto.   

Abstract

OBJECTIVES: To investigate the impact of pulmonary exacerbations on the health-related quality of life (HRQOL) of patients with cystic fibrosis (CF) and to elucidate factors that are associated with changes in HRQOL post-exacerbation. STUDY
DESIGN: Participants completed questionnaires at a pre-exacerbation visit, at the beginning of the exacerbation, and at the post-exacerbation visit. To measure HRQOL, we used the Child Health Questionnaire-Parent Form (PF-50) and the Medical Outcomes Study Short Form-36 (SF-36). We examined demographic, clinical, and treatment-related predictor variables for association with change in Physical Summary (PhS) and Psychosocial Summary (PsS) HRQOL scores after an exacerbation.
RESULTS: We collected data from 48 subjects. Patients experiencing exacerbations who were treated as outpatients had a mean (SD) age of 19.5 (12.7) years and a mean pre-exacerbation forced expiratory volume in 1 second (FEV(1)) of 70% (36%) of predicted; 53% were female. Patients treated as inpatients had a mean age of 14.6 (5.5) years and a mean FEV(1) of 56% (24%); 56% were female. In univariate analyses, exacerbations were associated with a statistically significant decrease in FEV(1) (-10.0%) and PhS scores (-4.5 points). PsS scores did not significantly change with exacerbations (-0.7 points). In multivariable analyses examining change between pre-exacerbation and post-exacerbation visits, no variables were significantly associated with change in PhS scores. However, not being hospitalized for the exacerbation was associated with deterioration in PsS scores, and being hospitalized was associated with improvement in PsS scores (beta coefficient: 9.4; P <.01) by the post-exacerbation visit. Results were similar from the exacerbation to the post-exacerbation visit.
CONCLUSION: In patients with CF, on average, pulmonary exacerbations affect physical HRQOL more than psychosocial HRQOL. Being hospitalized for exacerbations is associated with improvement in psychosocial HRQOL after exacerbations, whereas not being hospitalized is associated with deterioration.

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Year:  2004        PMID: 15192614     DOI: 10.1016/j.jpeds.2004.02.032

Source DB:  PubMed          Journal:  J Pediatr        ISSN: 0022-3476            Impact factor:   4.406


  9 in total

1.  Self-reported physical and psychological symptom burden in adults with cystic fibrosis.

Authors:  Gregory S Sawicki; Deborah E Sellers; Walter M Robinson
Journal:  J Pain Symptom Manage       Date:  2008-01-22       Impact factor: 3.612

Review 2.  Developmental and psychosocial issues in cystic fibrosis.

Authors:  Michelle M Ernst; Mark C Johnson; Lori J Stark
Journal:  Child Adolesc Psychiatr Clin N Am       Date:  2010-04

3.  Associations between illness perceptions and health-related quality of life in adults with cystic fibrosis.

Authors:  Gregory S Sawicki; Deborah E Sellers; Walter M Robinson
Journal:  J Psychosom Res       Date:  2010-08-10       Impact factor: 3.006

4.  The evidence regarding exercise training in the management of cystic fibrosis: a systematic review.

Authors:  Michael J Shoemaker; Heather Hurt; Leah Arndt
Journal:  Cardiopulm Phys Ther J       Date:  2008-09

5.  Changes in pediatric health-related quality of life in cystic fibrosis after IV antibiotic treatment for pulmonary exacerbations.

Authors:  Avani C Modi; Crystal S Lim; Kimberly A Driscoll; Carrie Piazza-Waggoner; Alexandra L Quittner; Jamie Wooldridge
Journal:  J Clin Psychol Med Settings       Date:  2010-03

6.  Longitudinal trends in health-related quality of life in adults with cystic fibrosis.

Authors:  Edward J Dill; Ree Dawson; Deborah E Sellers; Walter M Robinson; Gregory S Sawicki
Journal:  Chest       Date:  2013-09       Impact factor: 9.410

Review 7.  Patient-reported outcomes in cystic fibrosis.

Authors:  Christopher H Goss; Alexandra L Quittner
Journal:  Proc Am Thorac Soc       Date:  2007-08-01

Review 8.  Using bacterial biomarkers to identify early indicators of cystic fibrosis pulmonary exacerbation onset.

Authors:  Geraint B Rogers; Lucas R Hoffman; Matt W Johnson; Nicole Mayer-Hamblett; Jürgen Schwarze; Mary P Carroll; Kenneth D Bruce
Journal:  Expert Rev Mol Diagn       Date:  2011-03       Impact factor: 5.225

9.  Plasma sCD14 as a biomarker to predict pulmonary exacerbations in cystic fibrosis.

Authors:  Bradley S Quon; David A Ngan; Pearce G Wilcox; S F Paul Man; Don D Sin
Journal:  PLoS One       Date:  2014-02-20       Impact factor: 3.240

  9 in total

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