Systemic lupus erythematosus in a multiethnic lupus cohort (LUMINA). XVII. Predictors of self‐reported health‐related quality of life early in the disease course

Authors:
  • GMGerald McGwin
    Gerald McGwin
  • AUAmérica Uribe
    América Uribe
  • AFAlan W. Friedman
    Alan W. Friedman
  • JRJeffrey M. Roseman
    Jeffrey M. Roseman
  • BFBarri J. Fessler
    Barri J. Fessler
  • HBHolly M. Bastian
    Holly M. Bastian
  • BBBruce A. Baethge
    Bruce A. Baethge
  • JRJohn D. Reveille
    John D. Reveille
  • FGfor the LUMINA Study Group
    for the LUMINA Study Group
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Abstract
Objective: To determine the baseline factors predictive of self‐reported health‐related quality of life (HRQOL) early in the course of systemic lupus erythematosus patients (SLE) from a multiethnic LUMINA (Lupus in Minorities: Nature versus nurture) cohort.Methods: LUMINA patients with ≥2 visits were studied. Self‐reported HRQOL was examined with the 8 subscales and 2 summary measures (the Physical Component Summary [PCS], and the Mental Component Summary [MCS]) of the Short Form 36 (SF‐36). Bivariable and multivariable analyses were done with the PCS, MCS and 8 subscales as the dependent variables. The analyses were performed including and excluding the corresponding SF‐36 measure from the independent variables. Age, sex, and ethnicity were included in all models. Time was modeled in all regressions.Results: A total of 1,351 visits (346 patients [80 Hispanics‐Texas, 34 Hispanics‐Puerto Rico, 126 African Americans, and 106 Caucasians]) were included in these analyses. Mean ± SD PCS and MCS scores were 36.7 ± 12.0 and 46.6 ± 11.5, respectively. The scores for the eight subscales of the SF‐36 were also lower than those for the general population. Baseline SF‐36 measures were highly predictive of subsequent HRQOL. In the same set of regressions, older age was found to consistently predict poor self‐reported HRQOL whereas fibromyalgia, helplessness, fatigue, and abnormal illness‐related behaviors were also predictive, but less consistently. Estimated adjusted variances in these regressions ranged from 23% (Role‐Emotional [RE]) to 43% (Physical Functioning [PF]).Conclusion: In patients with SLE, poor baseline HRQOL was highly predictive of subsequent poor HRQOL. Other predictive variables of poor functioning were primarily psychological/behavioral and socioeconomic‐demographic.

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