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
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, 34Hispanics-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. KEY WORDS. Systemic lupus erythematosus; Outcome; Short Form 36; Ethnicity; Quality of life.
INTRODUCTIONAlthough patients with systemic lupus erythematosus (SLE) have a decreased life expectancy as compared with the general population, most live with their disease for many years (1-3). Studies of SLE outcome cannot be limited to those of survival/mortality, disease activity, and damage. International convened groups dealing primarily with lupus (Systemic Lupus International Collaborating Clinics [SLICC]) or with outcome (Outcome Measures for Arthritis Clinical Trials), have recommended that a measure of quality of life/self-reported functioning be included in SLE outcome studies (4 -7). We included, therefore, a self-reported measure of function, the Short Form (8,9) in the assessment of patients from the multiethnic US Lupus in Minorities: Nature versus nurture (LUMINA) (10 -12) cohort. The SF-36 self-reported functioning, a health-related quality of life (HRQOL) instrument, allows for comparison between patients with different chronic disorders and the general population (13)(14)(15)(16)(17)(18)(19)(20). Correlates of better self-reported physical health functioning in cross-sectional SLE studies include younger age, better self-efficacy f...