Health-related quality of life in persons with West Nile virus infection: a longitudinal cohort study
Abstract Background West Nile virus (WNV) infections are predominantly asymptomatic, although almost 1% become neuroinvasive and debilitating. We describe the impact of neuroinvasive and non-neuroinvasive disease on patient health-related quality of life (HRQoL). Methods Short Form 36 questionnaire...
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doaj-8fe653941a5740fe9ec23526cdea58b42020-11-24T23:44:03ZengBMCHealth and Quality of Life Outcomes1477-75252017-10-0115111010.1186/s12955-017-0787-5Health-related quality of life in persons with West Nile virus infection: a longitudinal cohort studyMan Wah Yeung0George Tomlinson1Mark Loeb2Beate Sander3Public Health OntarioInstitute of Health Policy, Management and Evaluation, University of TorontoDepartment of Pathology and Molecular Medicine, McMaster UniversityPublic Health OntarioAbstract Background West Nile virus (WNV) infections are predominantly asymptomatic, although almost 1% become neuroinvasive and debilitating. We describe the impact of neuroinvasive and non-neuroinvasive disease on patient health-related quality of life (HRQoL). Methods Short Form 36 questionnaire data came from a Canadian WNV cohort (Loeb 2008) of 154 patients followed for up to three years. We generated health utilities using the SF-6D. We calculated mean utility scores throughout follow-up and examined predictors using a linear mixed-effects model. We summarized HRQoL post-acute infection as: (i) long-term utility (mean of scores one year onward); (ii) area under the curve (AUC) one year onward. We examined predictors using beta regression. We used multiple imputation for sensitivity analysis. Results Mean utility scores improved from 0.59 (95% CI: 0.38, 0.93) at baseline to 0.77 (0.53, 1) at six months, before plateauing for the remaining two years. Mean long-term utility was 0.81 (0.78, 0.85) and mean AUC was 0.80 (0.76, 0.84). Patients with neuroinvasive disease had consistently worse scores than their non-neuroinvasive counterparts, with the gap nearly closed after six months. After adjusting for confounding, neuroinvasive disease was not a significant predictor of HRQoL either throughout follow-up or post-acute infection. Rather, number of comorbidities and baseline utility scores were. Sensitivity analysis showed similar findings. Conclusions Patients with WNV infection reported low HRQoL during acute illness, but improved rapidly by six months, regardless of neuroinvasive disease status. This is the first study reporting health utilities for WNV infection.http://link.springer.com/article/10.1186/s12955-017-0787-5West Nile virusHealth-related quality of lifeShort-form 36Short-form 6DPreferences |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Man Wah Yeung George Tomlinson Mark Loeb Beate Sander |
spellingShingle |
Man Wah Yeung George Tomlinson Mark Loeb Beate Sander Health-related quality of life in persons with West Nile virus infection: a longitudinal cohort study Health and Quality of Life Outcomes West Nile virus Health-related quality of life Short-form 36 Short-form 6D Preferences |
author_facet |
Man Wah Yeung George Tomlinson Mark Loeb Beate Sander |
author_sort |
Man Wah Yeung |
title |
Health-related quality of life in persons with West Nile virus infection: a longitudinal cohort study |
title_short |
Health-related quality of life in persons with West Nile virus infection: a longitudinal cohort study |
title_full |
Health-related quality of life in persons with West Nile virus infection: a longitudinal cohort study |
title_fullStr |
Health-related quality of life in persons with West Nile virus infection: a longitudinal cohort study |
title_full_unstemmed |
Health-related quality of life in persons with West Nile virus infection: a longitudinal cohort study |
title_sort |
health-related quality of life in persons with west nile virus infection: a longitudinal cohort study |
publisher |
BMC |
series |
Health and Quality of Life Outcomes |
issn |
1477-7525 |
publishDate |
2017-10-01 |
description |
Abstract Background West Nile virus (WNV) infections are predominantly asymptomatic, although almost 1% become neuroinvasive and debilitating. We describe the impact of neuroinvasive and non-neuroinvasive disease on patient health-related quality of life (HRQoL). Methods Short Form 36 questionnaire data came from a Canadian WNV cohort (Loeb 2008) of 154 patients followed for up to three years. We generated health utilities using the SF-6D. We calculated mean utility scores throughout follow-up and examined predictors using a linear mixed-effects model. We summarized HRQoL post-acute infection as: (i) long-term utility (mean of scores one year onward); (ii) area under the curve (AUC) one year onward. We examined predictors using beta regression. We used multiple imputation for sensitivity analysis. Results Mean utility scores improved from 0.59 (95% CI: 0.38, 0.93) at baseline to 0.77 (0.53, 1) at six months, before plateauing for the remaining two years. Mean long-term utility was 0.81 (0.78, 0.85) and mean AUC was 0.80 (0.76, 0.84). Patients with neuroinvasive disease had consistently worse scores than their non-neuroinvasive counterparts, with the gap nearly closed after six months. After adjusting for confounding, neuroinvasive disease was not a significant predictor of HRQoL either throughout follow-up or post-acute infection. Rather, number of comorbidities and baseline utility scores were. Sensitivity analysis showed similar findings. Conclusions Patients with WNV infection reported low HRQoL during acute illness, but improved rapidly by six months, regardless of neuroinvasive disease status. This is the first study reporting health utilities for WNV infection. |
topic |
West Nile virus Health-related quality of life Short-form 36 Short-form 6D Preferences |
url |
http://link.springer.com/article/10.1186/s12955-017-0787-5 |
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