scholarly journals Surgically treated acromegaly patients have a similar quality of life whether controlled by surgery or requiring additional medical therapy (QuaLAT Study)

Pituitary ◽  
2021 ◽  
Author(s):  
Muhammad Fahad Arshad ◽  
Oluwafunto Ogunleye ◽  
Richard Ross ◽  
Miguel Debono
Keyword(s):  
Quality Of Life ◽  
Medical Treatment ◽  
Physical Component Score ◽  
Healthy Controls ◽  
Component Score ◽  
Post Surgery ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Purpose There is no consensus on quality of life (QOL) in patients with acromegaly requiring medical treatment after surgery compared with those achieving remission by surgery alone. Methods QuaLAT is a cross-sectional study comparing QOL in surgery-only treated acromegaly patients versus those requiring medical treatment post-surgery. Patients attending clinics were identified and divided into—Group 1: patients who had surgery only and were in biochemical remission, Group 2: all patients on medical treatment post-surgery, Group 3: patients from Group 2 with biochemical control. Participants were asked to fill three questionnaires; Acromegaly Quality of Life Questionnaire (ACROQOL), 36-Item Short Form Survey (SF36), and Fatigue Severity Scale (FSS). Results There were 32 patients in Group 1 and 25 in Group 2. There was no difference in QOL scores between groups 1 and 2, as measured by ACROQOL (mean difference [MD] = − 2.5, 95% CI − 16.6 to 11.6; p = 0.72), SF36v2 [Physical component score (PCS) MD = − 4.9, 95% CI − 10.9 to 1.2; p = 0.12; mental component score MD = − 3.0, 95% CI − 10.5 to 4.4; p = 0.44], or FSS (MD = − 0.004, 95% CI − 1.14 to 1.33; p = 0.1). Comparison between groups 1 and 3 however showed that PCS (and 3 subdomains) was significantly better in group 3 (MD = − 8.3, 95% CI − 14.8 to -1.8; p = 0.01). All three QOL scores were lower when compared with healthy controls. Conclusions Medical treatment not only achieves a QOL comparable to surgery, it may also be associated with better QOL in physical subdomains. When compared with healthy controls, QOL remains worse in treated acromegaly patients compared to controls.

scholarly journals Medical Treatment Achieves Similar Quality of Life to Surgically Treated Acromegaly Patients in Remission: The QuaLAT Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A522-A522
Author(s):  
Muhammad Fahad Arshad ◽  
Oluwafunto Ogunleye ◽  
Richard John M Ross ◽  
Miguel Debono
Keyword(s):  
Quality Of Life ◽  
Medical Treatment ◽  
Physical Component Score ◽  
Life Questionnaire ◽  
Healthy Controls ◽  
Quality Of Life Questionnaire ◽  
Component Score ◽  
Group 2 ◽  
Group 1

Abstract Background: Quality of life (QOL) in acromegaly has been a subject of interest in several published studies; however, there is no consensus on how QOL in patients who require medical treatment after surgery compares with those who achieve remission by surgery only. Aim: Quality of life after acromegaly treatment (QuaLAT) is a case-control questionnaire-based study with the aim to compare the QOL in those who were treated with surgery only with those who required medical treatment after surgery at a single tertiary centre for acromegaly. Methods: Patients with acromegaly attending endocrinology clinics were identified via our database. These were matched on the duration of disease into those who underwent surgery and went into disease remission biochemically (Group 1), and those who did not achieve biochemical remission after surgery and therefore required further medical treatment to control the disease (Group 2). Participants were then asked to fill three questionnaires to measure their QOL; Acromegaly Quality of Life Questionnaire (ACROQOL), and two generic questionnaires; 36-Item Short Form Survey (SF36) v2, and Fatigue Severity Scale (FSS). Results: 20 patients from each group participated in the study. The mean±SD duration of acromegaly (years) was similar in the two groups (9.8±6.9 vs 9.7±6.9 p=0.653). The majority of patients in the medical group were on somatostatin analogues, either alone or in combination (n=14), with four and two patients on cabergoline and pegvisomant alone respectively. There was no difference in QOL scores between groups 1 & 2, as measured by ACROQOL (mean score±SD 54.4±24.8 vs 55.3±26.1 p=0.765), SF36v2 (Physical component score 40.1± 11.1 vs 45.6±12.0 p=0.235; mental component score 41.7±13.0 vs 43.1±16.4 p=0.601), or FSS (mean score±SD 4.4±2.2 vs 4.5±2.0 p=0.985) questionnaires. There was no difference in ages between both groups and there were 75% females in group 1 and 45% in group 2. When compared with healthy controls as reported in the published literature, all three QOL scores were lower in our cohort [1-3]. Conclusions: Medical treatment achieves similar QOL to surgically treated acromegaly patients in remission in the long term. When compared with healthy controls, QOL remains worse in treated acromegaly patients. References:1. Webb, S.M., et al., Validity and clinical applicability of the acromegaly quality of life questionnaire, AcroQoL: a 6-month prospective study. Eur J Endocrinol, 2006. 155(2): p. 269-77.2. Jenkinson, C., et al., Assessment of the SF-36 version 2 in the United Kingdom. J Epidemiol Community Health, 1999. 53(1): p. 46-50.3. Ongre, S.O., et al., Progression of fatigue in Parkinson’s disease -A nine-year follow-up. Eur J Neurol, 2020.

Patient-reported outcomes for determining prognostic groups in veterans with stage IV solid tumors starting systemic therapy.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 48-48
Author(s):  
Victor Tsu-Shih Chang ◽  
Charles B. Scott ◽  
Melanie L. Gonzalez ◽  
Jan Einhorn ◽  
Houling Yan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Solid Tumors ◽  
Systemic Therapy ◽  
Stage Iv ◽  
Group 4 ◽  
Prognostic Groups ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

48 Background: A Recursive Partitioning Analysis (RPA) prognostic algorithm based on quality of life and symptoms predicted 4 groups with distinct median survivals in patients with metastatic solid tumors receiving chemotherapy (ASCO 2013, Abst 9567). We update our findings. Methods: The RPA algorithm is based upon Karnofsky performance status (KPS), Functional Assessment of Cancer Therapy (FACT) physical well-being (PWB) subscale, and Memorial Symptom Assessment Scale Short Form (MSAS-SF) physical symptom distress (PHYS) subscale. Starting in 2007, a convenience sample of Veterans who were prescribed systemic treatment for their cancer was enrolled in an IRB approved protocol, and completed quality of life (FACT- G) and symptom (MSAS SF) questionnaires at the first cycle of treatment. We analyzed records of patients with stage IV metastatic solid tumors enrolled through June 2013, and determined survival as of June 15, 2014. Analyses were performed with STATA 11.0. Results: There were 97 patients(pts). The median age was 64 yrs, range 27-88. Males comprised 95 (98%) pts. First line chemotherapy was given to 78 (80%) pts. The most common primary sites were lung cancer 33 (35%), prostate 17 (17%) and colon 11 (11%) pts. Median KPS was 90% range 40-100%, PWB median 23 (range 6-28), and MSAS SF median PHYS 0.76 (range 0-3.2). Overall median survival was 285 days (range 6-2,358) and 80 pts (82%) had died. There was 1 pt in group 1, 58 in group 2, 12 in group 3, and 23 in group 4. The patient in group 1 had uterine sarcoma. Median survival (days) by RPA group was 155 for group 1, 177 for group 2, 292 for group 3, and 674 for group 4 (p=.011). Conclusions: These preliminary findings suggest that this algorithm is capable of dividing patients with metastatic solid tumor who are starting systemic therapy into prognostic groups. Further development is indicated.

scholarly journals Increased serum interleukin-9 and interleukin-1β are associated with depression in type 2 diabetes patients

2020 ◽  
Vol 78 (5) ◽  
pp. 255-261 ◽  
Author(s):  
Prabhat VARSHNEY ◽  
Rizwana PARVEEN ◽  
Mohd Ashif KHAN ◽  
Sunil KOHLI ◽  
Nidhi B. AGARWAL
Keyword(s):  
Quality Of Life ◽  
Positive Association ◽  
Diabetic Patients ◽  
Serum Samples ◽  
Type 2 Diabetic Patients ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

ABSTRACT Background: Co-morbid diabetes and depression are prevalent chronic conditions negatively affecting quality of life (QoL). Inflammation has been considered as an integral mechanism in patients with both diabetes and depression. Objective: The aim of the present study was to investigate depression and its association with interleukins (IL)-1β and IL-9 in type 2 diabetic patients (T2DM) and controls. The QoL in diabetic patient was also assessed. Methods: Eighty subjects were included, distributed among three groups: Group 1 - Healthy controls; Group 2 - T2DM patients without depression; Group 3 - T2DM patients with depression. Depression and QoL were assessed using Patient Health Questionnaire (PHQ-9) and The Audit of Diabetes-Dependent QoL (ADDQoL), respectively. IL-1β and IL-9 were measured in serum samples of all the patients using ELISA kit. Results: The PHQ score in the Group 3 was significantly higher as compared to Group 1. The ADDQoL scores in the Group 3 were significantly higher as compared to Group 2. Levels of IL-9 and IL-1β were elevated in Group 3, as compared to the other groups. Conclusion: This study showed positive association between depression and IL-1β, IL-9 in T2DM patients. Additionally, the diabetic patients have poorer quality of life, which is further worsened by the presence of depression. Thus, routine assessment for the presence of depression is suggested in T2DM patients.

scholarly journals Comparative characteristics of the quality of life of asthma patients with different types of airway hyperresponsiveness to physical stimules

2021 ◽  
pp. 55-61
Author(s):  
N. L. Perelman
Keyword(s):  
Quality Of Life ◽  
Airway Hyperresponsiveness ◽  
Group 4 ◽  
Sf 36 ◽  
Different Types ◽  
Asthma Patients ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Aim. To compare the nature and degree of influence of different types of airway hyperresponsiveness (AHR) on the general and specific quality of life (QoL) of patients with asthma and control over the disease.Materials and methods. 234 patients with mild-to-moderate asthma, aged from 18 to 60 years old, were interviewed and examined. Depending on the presence of one or another type of AHR, 4 groups were formed: group 1 included 60 patients with cold AHR, group 2 – 75 patients with hypoosmotic AHR, group 3 – 35 patients with hyperosmotic AHR, group 4 – 64 patients with exercise-induced bronchoconstriction (EIB). QoL and the state of the emotional sphere were assessed using the SF-36, AQLQ, HADS questionnaires. The level of asthma control was determined using the ACT questionnaire. Lung function was assessed by spirometry.Results. When comparing QoL between groups, statistical differences were obtained for most of the SF-36 scales, with the exception of the domains “Role Physical” (RP) and “Bodily Pain” (BP), and their presence and significance varied depending on the types of AHR being compared. The lowest QoL indices were found in group 1 of patients with cold AHR according to the domains “Physical Activity” (PA), RP, BP, and “Role Emotional” (RE). The lowest indices for the domains “General Health” (GH), “Vitality” (V) and “Mental health” (MH) were found in the respondents of the 2nd group. Most of the highest QoL indicators in the compared groups were found in patients of group 4 with EIB in the domains PA, RP, V, RE, and MH. When carrying out a comparative analysis, the maximum number of significant differences was found between the groups with cold AHR and EIB. A comparative study of QoL using a special AQLQ questionnaire showed the lowest indices for the “Activity” and “Symptoms” domains in groups 1 and 2 of asthma patients. In addition, in group 1, the minimum QoL values were recorded for the “General QoL” domain (3.6±0.2 points), and in group 2, for the “Environment” domain (2.9±0.3 compared with 3.9±0.2 points in group 3, p<0.01).Conclusion. This study has demonstrated the multifaceted effect of AHR on health-related QoL, dependent on sensitivity to a particular physical stimulus and the season of maximum trigger action. The subjective assessment of psychosocial functioning is most differentiated according to the GH domain of the SF-36 questionnaire. The greatest negative impact on the QoL indices is exerted by the cold and hypoosmotic AHR, the least – by the EIB. The assessment of QoL allows to get a full picture of the perception of the patient's health level at the moment and in the given conditions.

scholarly journals The effect of transportation modality to dialysis facilities on health-related quality of life among hemodialysis patients: results from the Japanese Dialysis Outcomes and Practice Pattern Study

2019 ◽  
Vol 13 (4) ◽  
pp. 640-646 ◽  
Author(s):  
Masahiko Yazawa ◽  
Kenji Omae ◽  
Yugo Shibagaki ◽  
Masaaki Inaba ◽  
Kazuhiko Tsuruya ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Practice Pattern ◽  
Dialysis Facility ◽  
Health Related ◽  
Group 3 ◽  
Group 2 ◽  
Mean Differences ◽  
Dialysis Outcomes ◽  
Group 1

Abstract Background For hemodialysis (HD) patients, travel to the dialysis facility is an issue that can affect their quality of life (QOL), both physically and mentally. However, evidence on this association of transportation modality with health-related QOL (HRQOL) is scarce. Methods We conducted a cohort study among maintenance HD patients participating in the Japanese Dialysis Outcomes and Practice Pattern Study Phase 5. The study included patients who were functionally independent and able to walk. The primary exposure was the means of transportation to the dialysis facility, categorized into three groups, namely transportation by other drivers (Group 1), transportation via self-driving (Group 2) and transportation by bicycle or walking with or without public transportation (Group 3). The primary outcomes were physical and mental health composite scores (PCS and MCS) in the 12-item Short Form at 1 year after study initiation. Results Among 1225 eligible patients (Group 1, 34.4%; Group 2, 45.0%; Group 3, 20.7%), 835 were analyzed for the primary outcomes. Linear regression analyses revealed that patients in Groups 2 and 3 had significantly higher PCS and MCS at 1 year than those in Group 1 {adjusted mean differences of PCS 1.42 [95% confidence interval (CI) 0.17–2.68] and 1.94 [95% CI 0.65–3.23], respectively, and adjusted mean differences of MCS 2.53 [95% CI 0.92–4.14] and 2.20 [95% CI 0.45–3.95], respectively}. Conclusions Transportation modality was a significant prognostic factor for both PCS and MCS after 1 year in maintenance HD patients.

Abstract 14421: Association Between Meeting Daily Step Count Goals With Ambulatory Function and Quality of Life in Patients With Claudication

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Andrew W Gardner ◽  
Polly Montgomery ◽  
Ming Wang ◽  
Biyi Shen
Keyword(s):  
Quality Of Life ◽  
Ankle Brachial Index ◽  
Group Differences ◽  
Chronic Obstructive ◽  
Daily Step ◽  
Distance Score ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Introduction: The aims were to determine (a) whether patients with peripheral artery disease (PAD) who walked at least 7,000 and 10,000 steps/day had better ambulatory function and health-related quality of life (HRQoL) than patients who walked less than 7,000 steps/day, and (b) whether these group differences persisted after adjusting for covariates. Hypothesis: Patients who walk at least 7,000 steps/day have significantly better ambulatory function, as measured by greater 6-minute walk distance (6MWD), and better HRQoL, as measured by a higher distance score on the Walking Impairment Questionnaire (WIQ), than patients who walked less than 7,000 steps/day, and that patients who walked more than 10,000 steps/day would have the best values. Furthermore, group differences in the primary outcomes would persist after adjustment for covariates. Methods: Two hundred forty-eight patients were assessed on their daily activity for one week with a step activity monitor, and were grouped according to daily step counts as follows: Group 1 (<7,000 steps/day; n=153), Group 2 (7,000-9,999 steps/day; n=57), Group 3 (>10,000 steps/day; n=38). Primary outcomes were 6MWD and WIQ distance score, which is a disease-specific measurement of HRQoL. Results: Groups were different (p<0.05) on ankle/brachial index, and on prevalence of hypertension, diabetes, abdominal obesity, arthritis, and chronic obstructive pulmonary disease. Thus, these variables served as covariates in adjusted analyses, along with age, weight, and sex. 6MWD (mean±SD) was significantly different among the groups in unadjusted (p<0.01) and adjusted (p<0.01) analyses (Group 1=313±90 m, Group 2=378±84 m, Group 3=414±77 m), with Groups 2 and 3 having higher 6MWD than Group 1 (p<0.01). Similar results were found for the WIQ distance score (Group 1=30±30%, Group 2=45±35%, Group 3=47±34%; p<0.01). Conclusions: PAD patients who walked more than 7,000 and 10,000 steps/day had greater ambulatory function and HRQoL than patients who walked fewer than 7,000 steps/day, and this finding persisted after adjusting for covariates. The clinical significance is that PAD patients should be encouraged to walk more than 7,000 steps/day because this target is associated with greater ambulatory function and HRQoL

scholarly journals Influence of Physical Therapy and Cholinergic Medication on the Life Quality Parameters in Post-Stroke with the arm Motor Dysfunction

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Iriah Festus Uwa-Agbonikhena
Keyword(s):  
Quality Of Life ◽  
Physical Therapy ◽  
Functional Independence ◽  
Motor Dysfunction ◽  
Stroke Patients ◽  
Post Stroke ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Motor dysfunction makes the greatest contribution to the patient’s functional independence and has a significant impact on the quality of life (QOL) of post-stroke patients. The objective of the research was to evaluate the impact of different physical therapy approaches and choline alphoscerate on the functional independence and quality of life in patients in 1 year after ischemic stroke. Materials and methods. There were 104 patients examined in 1-year period after first anterior circulation ischemic stroke. Neurological status, functional independence and QOL were assessed according to the National Institute of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), Functional Independence Measurement (FIM) and Stroke Specific Quality of Life Scale (SS-QOL). Patients in Group 1 received secondary stroke prevention therapy and performed the exercises complex for general muscle function improvement for 2 months; patients in Group 2 also performed the exercise complex for hand motility improvement for 2 months; patients in Group 3 received choline alphoscerate 400 mg twice a day for 2 months in addition to the abovementioned physical therapy. Results. 2 months of physical therapy in Group 1 resulted in increase of “Transfer” and subtotal motor scores. A significant increase in the “Self-care”, “Transfer” and therefore subtotal motor and total scores was observed in the patients in Group 2 and Group 3; the motor subtotal and total scores in Group 3 were 11.4% and 11.6 % higher than the same indices in Group 1, respectively. The most significant improvement of QOL parameters was observed in patients in Group 3, whose total score increased by 36.8% from the baseline (p<0.05), and exceeded the same index of Group 1 by 17.1% (p<0.05). Conclusions. Adding of hand exercise into the physical therapy complex for post-stroke patients contributes to better upper extremity motor performance and therefore functional independence. Stimulation of cholinergic neurotransmission with the choline alphoscerate may also increase the efficacy of physical therapy and contribute to patients’ general mobility, upper extremity function and QOL.

scholarly journals The influence of HDBA organic complex with vitamin d and calcium on quality of life in individuals at high risk of fractures undergoing medical rehabilitation

2020 ◽  
Vol 97 (3) ◽  
pp. 153-159
Author(s):  
L.A. Marchenkova ◽  
E.V. Makarova ◽  
V.A. Vasileva
Keyword(s):  
Quality Of Life ◽  
High Risk ◽  
Food Supplement ◽  
Biologically Active ◽  
Medical Rehabilitation ◽  
Life Assessment ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

The aim of the study is to evaluate the effect of the biologically active food supplement «Osteomed Forte» on pain intensity and quality of life in patients with high risk of fractures undergoing medical rehabilitation. Materials and methods: Included men and women 40-80 years old, with high risk of fractures. Patients who had already taken antiresorbents were identified in group №1 - they were assigned the investigated product (IP): biologically active food supplement «Osteomed Forte». Patients who had not received antiresorption therapy were divided into two equal groups by simple randomization. Group №2 was assigned to IP. There were no IPs in group №3. All the subjects were conducted: 1. Pain Assessment Score (PAS); 2. Quality of Life Assessment (QUALEFFO-41). The examination was repeated immediately after the rehabilitation course as well as after 6 and 12 months. Results: The study enrolled 120 people (group №1 n=41, group №2 n=39, group №3 n=39): 10 men, 110 women, average age 65.51±7.92 years. After a course of rehabilitation in all groups, PAS was significantly reduced (2.7, 3.0, 3.5 points, respectively, p<0.01), and the QUALEFFO-41 scores improved on all scales (p<0.05). This trend continued after 6 months. After 12 months, a significantly lower PAS was in group №1 (4.0 as compared to 6.2 and 6.4 points, p<0.05). In group №1, QUALEFFO-41 indices were significantly better than the initial ones (p<0,05) and higher than in groups №2 and 3 «Pain», «Housework», «Mobility», «General Health», «Mental Health», «General Indicator» (p<0,05). Conclusion: In patients with a high risk of fractures, the course of medical rehabilitation improved the physical and mental components of QOL and reduced the pain syndrome. In patients who took IP as a basic therapy, the achieved effect was maintained after 3, 6, 12 months. In 1 year after the rehabilitation course, the groups receiving IP and antiresorption therapy had better QOL parameters, lower PAS and better bone metabolism indices.

scholarly journals Early and long-term results of surgical treatment of Hirschsprung's disease in children

2018 ◽  
Vol 99 (2) ◽  
pp. 230-234
Author(s):  
R S Polukhov
Keyword(s):  
Quality Of Life ◽  
Hospital Stay ◽  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
One Year ◽  
Group 1

Aim. To assess the safety, functional activity and quality of life of patients with Hirschsprung's disease operated by different methods. Methods. The study included 86 children operated on for Hirschsprung's disease. Patients were divided into four groups: group 1 - 44 (51.2%) patients underwent Duhamel-Martin procedure; group 2 - 14 (16.3%) patients underwent Soave-Boley procedure; group 3 - 22 (25.6%) patients underwent transanal endorectal resection; and group 4 - 16 (18.6%) patients underwent laparoscopical Soave-Georgeson procedure. The results were comparatively evaluated immediately and one year after the surgery. To assess the quality of life after surgery, a visual questionnaire Peds QLtm 4.0 was used. Results. Minimal duration of the surgery and related anesthesia was registered in groups 3 and 4, the difference with groups 2 and 3 being statistically significant (p <0.05). Duration of postoperative pain management in group 1 was 3.2±0.7 days, in group 2 - 3.3±0.7 days, while in groups 3 and 4 - 2.5±0.5 days (р ˂0.05). Minimal hospital stay after the surgery was registered in group 4 (9±2 days), which is less than in group 1 by 1.7 times, in group 2 - by 1,5 times (р ˂0.05). The second shortest hospital stay was observed in patients from group 3 (10±2 days): it was 1.4 and 1.3 times shorter tahn in groups 1 and 2, respectively (р ˂0.05). At the assessment of one-year functional results satisfactory results were obtained in group 1 in 20 (45.46%) patients, in group 2 - in 7 (50%), in group 3 - in 12 (54.55%), in group 4 - in 12 (75%) patients. Unfavorable results were observed in group 1 in 6 (13.64%) patients, in group 2 - in 2 (14.29%), in group 3 - in 2 (9.09%), in group 4 - in 0 (0%). The best quality of life according to all parameters was observed among patients from groups 3 and 4 (р ˂0.05). Conclusion. The quality of life of patients with Hirschsprung's disease after transanal endorectal resection and laparoscopic Soave-Georgeson procedure was higher than after Duhamel-Martin and Soave-Boley procedures; Soave-Boley procedure is preferable due to good regulation of the defecation act by patients.

scholarly journals Quality of Life of Patients on Maintenance Hemodialysis in Relation to Hemoglobin Level: A Multicenter Study from a Developing Country

2017 ◽  
Vol 7 (3) ◽  
pp. 198-204
Author(s):  
Shudhanshu Kumar Saha ◽  
Mohammad Abul Masur ◽  
Sohel Reza Choudhury ◽  
Md Abdul Wahab Khan ◽  
Masud Iqbal ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Kidney Disease ◽  
Short Form ◽  
Well Being ◽  
Maintenance Hemodialysis ◽  
Group 3 ◽  
Group 2 ◽  
Esrd Patients ◽  
Group 1

Background: Anemia is common in patients with end stage renal disease (ESRD) and is associated with impaired quality of life (QOL). This study was done to evaluate the QOL of ESRD patients on maintenance hemodialysis (MHD) with different levels of hemoglobin (Hb).Methods: This cross-sectional study was conducted from January to December 2013 on 135 adult ESRD patients on MHD for ?4 months, at hemodialysis units of three tertiary care hospitals in Dhaka, Bangladesh. The patients were divided into three groups based on Hb levels (Group 1: Hb <9 gm/dl, n=45, 33%; Group 2: Hb 9-11 gm/dl, n=53, 39% and Group 3: Hb >11 gm/dl, n=37, 28%), provided their Hb levels were stable [ie. maintained with erythropoietin (EPO) or blood transfusion (BT) or both] over the previous four months. Subjects were interviewed by principal investigator using Kidney Disease Quality of Life Short Form Tool (KDQOL-SF-36 version 1.3) consisting of two domains with 38 questions with each item put on a 0 to 100 range, higher scores indicating better QOL.Results: The mean age was 50+12 years with male predominance (male:female = 1.5:1). Mean duration of hemodialysis was 12±11.8 months (range 9 to 66 months). The average QOL score was 50. Comparison of QOL parameters between the three groups showed that symptoms/problems, effects of kidney disease, burden of kidney disease, cognitive function, quality of social interaction and sleep in the kidney disease specific domain as well as pain, emotional well-being, social function and energy/fatigue scale scores in the general health related domain were significantly higher in the group 2 and group 3 than group 1 patients (each with p<0.001). Comparison of QOL parameters between anemia correction measures like EPO (n=65, 48.2%), BT (n=42, 31.1%) or both (n=28, 20.7%) showed that the group receiving EPO alone had better QOL [symptom/ problem (p 0.043), burden of kidney disease (p 0.000), sexual function (p 0.000), pain (p 0.008) and energy/ fatigue (p 0.036)] compared to those getting BT or even BT plus EPO.Conclusion: Patients were found to have better QOL with higher Hb levels. The overall QOL can be improved significantly by correction of anemia.Birdem Med J 2017; 7(3): 198-204

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