Assessment of the quality of life of patients with echinococcosis in Gansu Province pre- and post-surgery based on the EQ-5D-5L questionnaire

doi:10.12140/j.issn.1000-7423.2024.02.008

Abstract

Abstract:

Objective To analyse the changes in quality of life of patients with echinococcosis in Gansu Province pre- and post-surgery, and evaluate the impact of surgical treatments on the patients’ quality of life. Methods The patients with echinococcosis underwent surgery and were managed under the National Project for Echinococcosis Control and Prevention in Gansu Province were surveyed using questionnaire and EQ-5D-5L questionnaire to collect basic information, first visit record, surgical performance, and the quality of life pre- and post-surgery. The data were analyzed by SPSS 19.0 and Origin 2021. Results A total of 856 cases collected, including 417 males and 439 females. The age ranges from 7 to 85 years, with an average of 53 years. There were 737 cases of CE patients, 14 cases of AE patients, and 105 cases of unclassified patients. The longest time from the first surgery to postoperative follow-up for patients with echinococcosis was 17.5 years, and the shortest was 1 month. The average time interval between the investigation and the first surgery was 7.4 years (89 months). The preoperative and postoperative health utility values for patients with echinococcosis were 0.910 ± 0.142 and 0.967 ± 0.067, respectively, showing a 6.3% improvement postsurgery (Z = -12.081, P < 0.05). The preoperative and postoperative visual analog scale (VAS) scores were 79.10 ± 16.00 and 86.25 ± 11.64, respectively, showing a 9.0% improvement postsurgery (Z = -15.292, P < 0.05). The health utility value difference in patients with echinococcosis ranged between -0.308 and 1.348, the VAS score difference ranged between -55 and 90. A total of 42.8% (366/856) patients had an increase in health utility value postsurgery, and 62.7% (537/856) of patients had an increase in VAS score postsurgery. The proportion of patients with reduction of difficulties in the five dimensions was 19.1% (818/4 280), unchanged was 76.5% (3 275/4 280), and those with stable overall health had higher health utility values (Z = -16.580, P < 0.05) and VAS scores (Z = -8.606, P < 0.05). The proportion of patients with increased difficulties was 4.4% (187/4 280), the average age of first operation in the group with decreased health utility value was higher than that in another group (Z = 4.393, P < 0.05). The average age of first operation in the group with decreased VAS score was higher than that in another group (Z = 3.154, P < 0.05). The patients’ health utility value (F = 12.957, P_trend < 0.05) and VAS score (F = 10.808, P_trend < 0.05) showed a trend of positive linear correlation with the extension of postsurgery time. Conclusion Surgical treatment could impact the quality of life for patients with echinococcosis.

Key words: Echinococcosis, EQ-5D-5L questionnaire, Surgical patients, Quality of life, Gansu Province

CLC Number:

R532.32

LIU Zehang, ZHANG Xiaojuan, YANG Guobing, LEI Jiaxi, LIU Baixue, WANG Ying, WANG Zhiyi, WANG Dong, FENG Yu, WANG Liying. Assessment of the quality of life of patients with echinococcosis in Gansu Province pre- and post-surgery based on the EQ-5D-5L questionnaire[J]. CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES, 2024, 42(2): 182-190.

Figures/Tables 8

Table 1

Fig. 1

Table 2

Fig. 2

Table 3

Table 4

Distribution of each level in each dimension of EQ-5D-5L before and after first surgical treatment in 856 patients with echinococcosis in Gansu Province

维度 Dimension	棘球蚴病患者人数（占比/%） No. patients with echinococcosis (Proportion/%)		CE患者人数（占比/%） No. patients with CE (Proportion/%)		AE患者人数（占比/%） No. patients with AE (Proportion/%)		未分型棘球蚴病患者人数（占比/%） No. patients with unclassified echinococcosis(Proportion/%)
维度 Dimension	手术前 Before surgery	手术后 After surgery	手术前 Before surgery	手术后 After surgery	手术前 Before surgery	手术后 After surgery	手术前 Before surgery	手术后 After surgery
行动能力 Mobility
没有困难 No problem	740(86.4)	792(92.5)	632(85.8)	676(91.7)	10(71.4)	13(92.9)	98(93.3)	103(98.1)
有一点困难 Slight problem	105(12.3)	64(7.5)	96(13.0)	61(8.3)	2(14.3)	1(7.1)	7(6.7)	2(1.9)
有中度困难 Moderate problem	7(0.8)	0	6(0.8)	0	1(7.1)	0	0	0
有严重困难 Severe problem	2(0.2)	0	1(0.1)	0	1(7.1)	0	0	0
极度困难 Extreme problem	2(0.2)	0	2(0.3)	0	0	0	0	0
自我照顾 Self-care
没有困难 No problem	752(87.9)	803(93.8)	645(87.5)	687(93.2)	10(71.4)	13(92.9)	97(92.4)	103(98.1)
有一点困难 Slight problem	90(10.5)	50(5.8)	81(11.0)	47(6.4)	2(14.3)	1(7.1)	7(6.7)	2(1.9)
有中度困难 Moderate problem	8(0.9)	3(0.4)	7(0.9)	3(0.4)	1(7.1)	0	0	0
有严重困难 Severe problem	3(0.4)	0	2(0.3)	0	1(7.1)	0	0	0
极度困难 Extreme problem	3(0.4)	0	2(0.3)	0	0	0	1(1.0)	0
日常活动 Usual activity
没有困难 No problem	677(79.1)	748(87.4)	574(77.9)	642(87.1)	10(71.4)	12(85.7)	93(88.6)	94(89.5)
有一点困难 Slight problem	146(17.1)	97(11.3)	137(18.6)	87(11.8)	2(14.3)	2(14.3)	7(6.7)	8(7.6)
有中度困难 Moderate problem	24(2.8)	8(0.9)	20(2.7)	5(0.7)	1(7.1)	0	3(2.9)	3(2.9)
有严重困难 Severe problem	6(0.7)	3(0.4)	4(0.5)	3(0.4)	1(7.1)	0	1(1.0)	0
极度困难 Extreme problem	3(0.4)	0	2(0.3)	0	0	0	1(1.0)	0
疼痛或不舒服 Pain or discomfort
没有疼痛或不舒服 No problem	468(54.7)	693(81.0)	393(53.3)	592(80.3)	9(64.3)	10(71.4)	66(62.9)	91(86.7)
有一点疼痛或不舒服 Slight problem	294(34.3)	157(18.3)	260(35.3)	140(19.0)	2(14.3)	4(28.6)	32(30.5)	13(12.4)
有中度疼痛或不舒服 Moderate problem	61(7.1)	6(0.7)	58(7.9)	5(0.7)	2(14.4)	0	1(1.0)	1(1.0)
有严重疼痛或不舒服 Severe problem	26(3.0)	0	20(2.7)	0	1(7.1)	0	5(4.8)	0
极度疼痛或不舒服 Extreme problem	7(0.8)	0	6(0.8)	0	0	0	1(1.0)	0
焦虑或沮丧 Anxiety/depression
没有焦虑或沮丧 No problem	587(68.6)	749(87.5)	498(67.6)	647(87.8)	8(57.1)	10(71.4)	81(77.1)	92(87.6)
有一点焦虑或沮丧 Slight problem	226(26.4)	100(11.7)	204(27.7)	85(11.5)	4(28.6)	4(28.6)	18(17.1)	11(10.5)
有中度焦虑或沮丧 Moderate problem	33(3.9)	6(0.7)	30(4.1)	5(0.7)	0	0	3(2.9)	1(1.0)
有严重焦虑或沮丧 Severe problem	9(1.1)	0	5(0.7)	0	2(14.3)	0	2(1.9)	0
极度焦虑或沮丧 Extreme problem	1(0.1)	1(0.1)	0	0	0	0	1(1.0)	1(1.0)

Table 4

Table 5

Fig. 3

References 21

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维度 Dimension	有一点困难 Slight problems	有中度困难 Moderate problems	有严重困难 Severe problems	极度困难 Extreme problems
行动能力 Mobility	0.066	0.158	0.287	0.345
自我照顾 Self-care	0.048	0.016	0.210	0.253
日常活动 Usual activities	0.045	0.107	0.194	0.233
疼痛/不舒服 Pain/discomfort	0.058	0.138	0.252	0.302
焦虑/沮丧 Anxiety/depression	0.049	0.118	0.215	0.258

生命质量指标 Index of quality of life	[0，1）年（n = 40） [0, 1) year (n = 40)	[1，5）年（n = 215） [1, 5 ）years (n = 215)	[5，20] 年（n = 601） [5, 20] years (n = 601)	F₁	P	F₂	P_trend
健康效用值 Health utility value	0.932 ± 0.115	0.961 ± 0.072	0.971 ± 0.060	7.385	< 0.05	12.957	< 0.05
VAS评分/分 Visual analogue scalescore	81.55 ± 14.84	85.07 ± 12.17	86.99 ± 11.11	5.618	< 0.05	10.808	< 0.05

测量内容 Measurement contents	手术前 Before surgery	手术后 After surgery	Z值 Z value	P值 P value
棘球蚴病患者 Patients with echinococcosis
健康效用值 Health utility value	0.910 ± 0.142	0.967 ± 0.067	-12.081	< 0.05
VAS评分/分 Visual analogue scalescore	79.10 ± 16.00	86.25 ± 11.64	-15.292	< 0.05
CE患者 Patients with CE
健康效用值 Health utility value	0.909 ± 0.136	0.966 ± 0.067	-11.432	< 0.05
VAS评分/分 Visual analogue scalescore	79.08 ± 15.91	86.29 ± 11.12	-14.652	< 0.05
AE患者 Patients with AE
健康效用值 Health utility value	0.817 ± 0.320	0.955 ± 0.077	-1.906	> 0.05
VAS评分/分 Visual analogue scalescore	77.14 ± 18.78	79.29 ± 18.28	-0.400	> 0.05
未分型患者 Patients with unclassified echinococcosis
健康效用值 Health utility value	0.928 ± 0.143	0.974 ± 0.064	-3.642	< 0.05
VAS评分/分 Visual analogue scalescore	79.50 ± 16.43	86.91 ± 13.80	-5.092	< 0.05

五维度困难程度变化 Changes of five-dimensional difficulty degree	棘球蚴病患者人数（占比/%）No. patients with echinococcosis (Proportion/%)	CE患者人数（占比/%） No. patients with CE (Proportion/%)	AE患者人数（占比/%） No. patients with AE (Proportion/%)	未分型棘球蚴病患者人数（占比/%） No. patients with unclassified echinococcosis (Proportion/%)
行动能力 Mobility
减轻 Alleviated	91(10.6)	81(11.0)	4(28.6)	6(5.7)
不变 Unchanged	732(85.5)	624(84.7)	10(71.4)	98(93.3)
加重 Aggravated	33(3.9)	32(4.3)	0	1(1.0)
自我照顾 Self-care
减轻 Alleviated	83(9.7)	72(9.8)	4(28.6)	7(6.7)
不变 Unchanged	747(87.3)	640(86.8)	10(71.4)	97(92.4)
加重 Aggravated	26(3.0)	25(3.4)	0	1(1.0)
日常活动 Usual activity
减轻 Alleviated	134(15.7)	121(16.4)	4(28.6)	9(8.6)
不变 Unchanged	670(78.3)	572(77.6)	9(64.3)	89(84.8)
加重 Aggravated	52(6.1)	44(6.0)	1(7.1)	7(6.7)
疼痛/不舒服 Pain/discomfort
减轻 Alleviated	305(35.6)	266(36.1)	5(35.7)	34(32.4)
不变 Unchanged	499(58.3)	426(57.8)	7(50.0)	66(62.9)
加重 Aggravated	52(6.1)	45(6.1)	2(14.3)	5(4.8)
焦虑/沮丧 Anxiety/depression
减轻 Alleviated	205(23.9)	182(24.7)	5(35.7)	18(17.1)
不变 Unchanged	627(73.2)	536(72.7)	8(57.2)	83(79.0)
加重 Aggravated	24(2.8)	19(2.6)	1(7.1)	4(3.8)