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Determinants of low health-related quality of life in patients with myelodysplastic syndromes: EUMDS Registry study.

ABSTRACT: Patients with myelodysplastic syndromes (MDS) frequently experience a significant symptom burden, which reduces health-related quality of life (HRQoL). We aimed to identify determinants of low HRQoL in patients recently diagnosed with MDS, for guiding early intervention strategies. We evaluated longitudinal data in 2205 patients with MDS during their first year after diagnosis. Median values of EQ-5D 3-level (EQ-5D-3L) index (0.78) and visual analog scale (VAS) score (0.70) were used as thresholds for low HRQoL. In addition, the 5 dimensions of EQ-5D-3L were analyzed for impairments (any level vs "no problem" category). After multiple imputation of missing values, we used generalized estimating equations (GEE) to estimate odds ratios (OR) for univariable determinant screening (P < .15), and to subsequently derive multivariable models for low HRQoL with 95% confidence intervals (CI). Multivariable GEE analysis showed the following independent determinants (OR, 95% CI) for low EQ-5D index: increased age (60-75 years: 1.33, 1.01-1.75; >75: 1.84, 1.39-2.45), female sex (1.70, 1.43-2.03), high serum ferritin level (≥1000 vs ≤300 μg/L: 1.41, 1.06-1.87), comorbidity burden (per unit: 1.11, 1.02-1.20), and reduced Karnofsky performance status (KPS, per 10 units: 0.62, 0.58-0.67). For low VAS score, additional determinants were transfusion dependence (1.53, 1.03-2.29), low hemoglobin <10 g/dL (1.34, 1.12-1.61), and high body mass index (≥30 vs 23-29.9 kg/m2: 1.26, 1.02-1.57). Sex, KPS, comorbidity burden, hemoglobin count, and transfusion burden were determinants for all EQ-5D dimensions. Low HRQoL is determined by multiple factors, which should be considered in the management and shared decision making of patients with MDS. This trial was registered at www.clinicaltrials.gov as #NCT00600860.

SUBMITTER: Stojkov I

PROVIDER: S-EPMC10275700 | biostudies-literature | 2023 Jun

REPOSITORIES: biostudies-literature

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Determinants of low health-related quality of life in patients with myelodysplastic syndromes: EUMDS Registry study.

Stojkov Igor I Conrads-Frank Annette A Rochau Ursula U Arvandi Marjan M Koinig Karin A KA Schomaker Michael M Mittelman Moshe M Fenaux Pierre P Bowen David D Sanz Guillermo F GF Malcovati Luca L Langemeijer Saskia S Germing Ulrich U Madry Krzysztof K Guerci-Bresler Agnès A Culligan Dominic J DJ Kotsianidis Ioannis I Sanhes Laurence L Mills Juliet J Puntscher Sibylle S Schmid Daniela D van Marrewijk Corine C Smith Alexandra A Efficace Fabio F de Witte Theo T Stauder Reinhard R Siebert Uwe U

Blood advances 20230601 12

Patients with myelodysplastic syndromes (MDS) frequently experience a significant symptom burden, which reduces health-related quality of life (HRQoL). We aimed to identify determinants of low HRQoL in patients recently diagnosed with MDS, for guiding early intervention strategies. We evaluated longitudinal data in 2205 patients with MDS during their first year after diagnosis. Median values of EQ-5D 3-level (EQ-5D-3L) index (0.78) and visual analog scale (VAS) score (0.70) were used as threshol ...[more]

PMID: 36607832

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Project description:IntroductionOne of COVID-19’s limitations is the reduced quality of life (QoL) caused by variety of underlying reasons. Even though multiple papers in the literature reveal a worsening of QoL after COVID-19, there is currently inadequate evidence on which patients’ QoL is impacted the most. Our study’s aim was to determine which patients’ quality of life was most compromised so that interventions for poor QoL should not be overlooked in the post-disease assessments of those in the risk group.Materials and methodsPatients referred to our pulmonary rehabilitation center for Long COVID symptoms had their dyspnea perception, body composition, exercise capacity, muscle strengths, and psychological state evaluated. In addition, SF-36 was used to assess their QoL. After obtaining all medical data, the patients were separated into three groups based on whether they had the disease as an outpatient, inpatient in the hospital, or in the intensive care unit. The Anova and Kruskal Wallis tests were utilized in the statistical analysis of demographic data among patient groups. Pearson’s test was used for normal distributions, whereas Spearman’s test was used for non-normal distribution analyses. The factors affecting QoL were investigated using multivariate linear regression analysis.ResultsThe majority of 173 study participants had poor QoL. Low exercise capacity (p= 0.026), impaired psychosocial status (p= 0.034 for anxiety, p= 0.022 for depression), and increased fatigue (p= 0.001) were the factors affecting SF-36’s physical component summary (PCS), whereas young age (p= 0.026), male sex (p= 0.037), impaired psychosocial status (p< 0.001 for anxiety, p= 0.002 for depression), and increased fatigue (p= 0.005) were the factors affecting the SF-36’s mental component summary (MCS).ConclusionYoung age, male sex, reduced exercise capacity, poor psychosocial status, and increased fatigue are predictors for impaired QoL after COVID19. Therefore, non-medical treatment options that improve QoL should be considered in the follow-up of these patients.

Dataset Information

Determinants of low health-related quality of life in patients with myelodysplastic syndromes: EUMDS Registry study.

Publications

Determinants of low health-related quality of life in patients with myelodysplastic syndromes: EUMDS Registry study.

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