Abstract
BackgroundPreviously, many studies have evaluated quality of life (QoL) in patients with ankylosing spondylitis (AS), however, none of them specifically investigated the correlation between pain-related disability measured by Oswestry Disability Index (ODI) and QoL in AS patients. In addition, the correlation between global kyphosis (GK) in lateral plain radiographs and QoL in AS patients remains unclear up to now. Therefore, this study aimed to evaluate QoL and correlation with clinical and radiographic variables in AS patients, especially to figure out the relationship about the pain-specific disability measured by ODI, GK and QoL.MethodsFrom January 2008 to November 2015, two hundred and forty-five consecutive patients with an average age of 36.2 ± 10.9 years (range, 17–66 years) satisfying the Modified New York Criteria for AS from a single institution were enrolled. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI) and Bath Ankylosing Spondylitis Global score (BAS-G) were applied to assess the disease activity, functional status, spinal mobility and overall feeling of AS patients, respectively. ODI was recorded to evaluate low back pain-related disability. QoL was evaluated by the Short Form-36 (SF-36). According to global kyphosis (GK) measured on standing lateral full-spine radiographs, the patients were divided into two groups: mild kyphotic group (GK < 70°,n = 176) and severe kyphotic group (GK ≥ 70°,n = 69).ResultsThe scores of BASDAI, BASFI, BASMI and ODI had significant negative correlations with all SF-36 subscale scores (P < 0.01). BASFI and BASMI scores of severe kyphotic group were much higher than those of mild kyphotic group, respectively (P = 0.005 and P = 0.001, respectively) and the score of physical function (PF) subscale in severe kyphotic group was significantly higher than that in mild kyphotic group (P = 0.046) as well. Notably, the scores of ODI, BASFI and BASMI were the major predictors of PF subscale score of SF-36.ConclusionsPoor QoL is significantly correlated with high disease activity, poor functional status and decreased spinal mobility in AS. GK is significantly associated with functional status, spinal mobility and QoL in AS patients. ODI, BASFI and BASMI are the major predictors of PF subscale of SF-36.
Highlights
Many studies have evaluated quality of life (QoL) in patients with ankylosing spondylitis (AS), none of them investigated the correlation between pain-related disability measured by Oswestry Disability Index (ODI) and QoL in Ankylosing spondylitis (AS) patients
The Erythrocyte sedimentation rate (ESR) of 119 (49%) patients and the C-reactive protein (CRP) of 176 (72%) patients were above normal range, respectively
It may lead to irreversible structural damage and the consequent reduction in functional status, limitation of Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) Bath ankylosing spondylitis disease activity index, Bath Ankylosing Spondylitis Functional Index (BASFI) Bath ankylosing spondylitis functional index, BASMI Bath Ankylosing Spondylitis Metrology Index, ODI Oswestry Disability Index physical mobility and poor QoL
Summary
Many studies have evaluated quality of life (QoL) in patients with ankylosing spondylitis (AS), none of them investigated the correlation between pain-related disability measured by Oswestry Disability Index (ODI) and QoL in AS patients. Stiffness and fatigue are cardinal complaints in AS patients [2, 3] These clinical symptoms and subsequent disease progression result in substantial functional limitations, gradual loss of spinal mobility and impairment of quality of life (QoL). SF-36 is the most commonly used measurement technique to assess the health-related QoL of AS patients [10,11,12,13,14,15,16,17,18] Among these studies, the relationship between QoL and disease activity or functional status has been investigated by many researchers [13,14,15,16]. Relatively fewer studies focused on the relationship between spinal mobility and QoL measured by SF-36 in AS [13, 17, 18]
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