Background

To assess health- related quality of life (HRQOL) with SF-12 and SF-36 and compare their abilities to predict mortality in chronic dialysis patients, after adjusting for traditional risk factors.

Methods

The Short-Form Health Survey (SF-36) with the embedded SF-12 was applied in 301 dialysis patients cross-sectionally. Physical and mental component summary (PCS-36, MCS-36, PCS-12, and MCS-12) scores were calculated. Clinical and demographic data were collected. Mortality (followed for up to 4.5 years) was analyzed with Kaplan Meier plots and Cox proportional hazards, after censoring for renal transplantation. Exclusion factors were observation time <2 months (n = 21) and missing component summary scores (n = 10 for SF-36; n = 28 for SF-12), thus 252 patient were included in the analyses.

Results

In 252 patients (60.2 ± 15.5 years, 65.9% males, dialysis vintage 9.0, IQR 5.0-23.0 months), mortality during follow-up was 33.7%.(85 deaths). Significant correlations were observed between PCS-36 and PCS-12 (ρ = 0.93, p < 0.001) and between MCS-36 and MCS-12 (ρ = 0.95, p < 0.001). Mortality rate was highest in patients in the lowest quartile of PCS-12 (χ2 = 15.3, p = 0.002) and PCS-36 (χ2 = 16.7, p = 0.001). MCS was not associated with mortality. Adjusted hazard ratios for mortality were 2.5 (95% CI 1.0-6.3, PCS-12) and 2.7 (1.1 – 6.4, PCS-36) for the lowest compared with the highest (“best perceived”) quartile of PCS.

Conclusion

Compromised HRQOL is an independent predictor of poor outcome in dialysis patients. The SF-12 provided similar predictions of mortality as SF-36, and may serve as an applicable clinical tool because it requires less time to complete.

Health status questionnaires provide standardized measures of patients’ perceptions of the impact of disease on their daily life and well-being. Factors associated with health status were examined in a sample of 58 outpatients with chronic obstructive pulmonary disease (COPD) and co-morbid anxiety and/or depression. A cross-sectional descriptive study was conducted with the following measures: The St. George’s Respiratory Questionnaire (SGRQ); the Beck Anxiety Inventory (BAI); the Beck Depression Inventory, 2nd edition (BDI); the Pittsburgh Sleep Quality Index (PSQI); and spirometry. Disease severity as measured with spirometry was not related to health status. Perceptions of poor health as implied by the health status scores were positively associated with symptoms of anxiety and depression, sleep disturbances, and level of daily functioning. There were statistically significant differences between men and women on COPD severity, age, and the BAI scores. The findings emphasize the importance of screening the patients at all stages of disease severity for anxiety, depression, and sleeping problems, in order to provide adequate care for these problems.