AB1246 PREDICTORS OF IMPAIRED QUALITY OF LIFE IN PATIENTS WITH SYSTEMIC DISEASES

Abstract

Background: Systemic diseases are heterogeneous diseases that represent one of the leading causes of disability in the industrialized world and can even reduce life. They are associated with high rates of disability, premature mortality, and significant social costs. Objectives: The objectives of our study were to evaluate the quality of life (QoL) of patients with systemic disease and a comparison between these patients, to search for factors predicting the impairment of quality of life during systemic diseases, and to evaluate work disability of those patients. Methods: We conducted a cross-sectional study at the Internal Medicine Department of the Farhat Hached Hospital in Sousse between July 2017 and September 2017. We investigated patients with systemic rheumatic, thrust or remission who were present as outpatients or were admitted to the ward during this period. The outcomes were baseline Short Form Health Survey physical (PCS) and mental (MCS) component summary scores QoL. Work disability was evaluated by the work productivity assessment impairment (WPAI) questionnaire. Correlations were calculated by the test t student or Anova factor test and comparison with chi2 test. Results: Two hundred thirty five patients were included, 183 females and 52 males. The average age was 48,3 years with extremes between 15 and 90 years old. Forty seven per cent of the population had work during the study. The most frequent diseases were: Systemic lupus erythematosus (SLE) in 66 patients, Behcet syndrome in 33 patients and Sjogren primary syndrome (SPS) in 27 patients. Mean PCS were 52.55 ± 17.3 and MCS scores were 47.74 ±14.8. For the predictors related to patients: the age ((PCS: r=-0.250, p=0.000), (MCS: r=-0.160, p=0.014)), the presence of comorbidities (PCS p=0.003) and the low level of education (p=0.001) were significantly correlated with impaired QoL, the presence of profession was not significantly correlated with QoL. For the predictors related to the disease; inflammatory myositis influences most the QoL. Pulmonary manifestations (PCS: p=0.021, MCS: p=0.006) were the most correlated with impaired QoL. Disease index of activity was calculated in 3 diseases and it was significantly correlated with impaired QoL; SLE ((PCS; r=-0.581, p=0.000),(MCS; r=-0.494,p=0.000)),SSP ((PCS; r=-0.500,p=0.007), (MCS; r=0.522, p=0.005)), Systemic sclerosis ((PCS; r=0.698, p=0.012), (MCS; r=0.710,p=0.01)). Work disability was evaluated in working patients: absenteeism was at 31.16±24, productivity impairment at 48.77 and systemic sclerosis was the most disease predictive of absenteeism and work disability (p=0.011). Conclusion: QoL may be severely impaired in patients suffering from systemic diseases. We studied for the first time the predictors of impaired QoL for all patients followed in our department. Our study concord with literature (1), beside the objective criteria resulting from clinical examination and biological investigations, it seems essential to take into account the individuality of each patient. This measure aims to further humanize medical practice and maintain the quality of life of patients.