Preadmission quality of life as predictor of outcome after acute care: The role of emotional well-being.

Preadmission quality of life as predictor of outcome after acute care: The role of emotional well-being.

QJM. 2017 Oct 27;:

Authors: Belayachi J, El Khattate A, Bizrane M, Madani N, Abouqal R

Abstract
Purpose: We sought to investigate whether preadmission quality of life could act as a predictor of mortality among acutely ill patients, and which dimension of QOL has the greater impact on outcomes.
Methods: Prospective cohort study including patients admitted to an acute medical unit (AMU) of Rabat Ibn Sina University Hospital, Morocco, between June and September 2014. Characteristics of patients were recorded at admission. The primary exposure was Preadmission quality of life recorded using Euroqol 5 dimensions three level (EQ-5D-3L) and the primary outcome was 90 days mortality. We fit a Cox proportional hazards model to assess their association. We constructed six prediction models; each model included either EQ5D index or one of the 5 dimensions. We allowed all continuous variables to have a nonlinear relationship with the primary outcome using restricted cubic spline with 3 knots.
Results: We included 251 patients. The mean EQ5D index was 0.46 ± 0.5. The design of each prediction model was based on the significant findings of the univariate analysis including; bedside EQ5D index or one of the 5 dimensions of the EQ5D; age, history of chronic disease, CCI, and hemoglobinemia. Multivariate Cox proportional adjusted hazard ratio derived from the six models, identified that EQ5D index was independently associated with 90 days mortality (HR:0.48;95%CI:0.25;0.91,P=0.02), and that anxiety and depression dimension has the greater impact on outcome (HR:2.97;95%CI:1.38;6.41,P=0.005).
Conclusions: This study revealed that preadmission HRQOL, and particularly pre-admission psychological HRQOL was associated with outcome of acutely ill patients 90 days after discharge.

PMID: 29088410 [PubMed - as supplied by publisher]

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