Health related quality of life in patients with community-acquired pneumococcal pneumonia in France.
Luiz Flavio Andrade, Grèce Saba, Jean-Damien Ricard, Jonathan Messika, Jacques Gaillat, Pierre Bonnin, Christian Chidiac, Hajnal-Gabriela Illes, Henri Laurichesse, Bruno Detournay, Patrick Petitpretz, Gérard de Pouvourville
Author Information
Luiz Flavio Andrade: ESSEC Business School, Avenue Bernard Hirsch, 95021, Cergy-Pontoise Cedex, France. andrade@essec.edu. ORCID
Grèce Saba: ESSEC Business School, Avenue Bernard Hirsch, 95021, Cergy-Pontoise Cedex, France.
Jean-Damien Ricard: Hôpital Louis Mourier, Assistance Publique Hôpitaux de Paris, Colombes, France.
Jonathan Messika: Hôpital Louis Mourier, Assistance Publique Hôpitaux de Paris, Colombes, France.
Jacques Gaillat: CH d'Annecy Genevois, Annecy, France.
Pierre Bonnin: CH d'Annecy Genevois, Annecy, France.
Christian Chidiac: Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France.
Hajnal-Gabriela Illes: Hôpital Gabriel Montpied, CHU de Clermont-Ferrand, Clermont-Ferrand, France.
Henri Laurichesse: Hôpital Gabriel Montpied, CHU de Clermont-Ferrand, Clermont-Ferrand, France.
Bruno Detournay: CEMKA-EVAL, Bourg-la-Reine, France.
Patrick Petitpretz: Hôpital André Mignot, Versailles, France.
Gérard de Pouvourville: ESSEC Business School, Avenue Bernard Hirsch, 95021, Cergy-Pontoise Cedex, France. pouvourville@essec.edu.
BACKGROUND: Community Acquired Pneumococcal Pneumonia is a lung infection that causes serious health problems and can lead to complications and death. The aim of this study was to observe and analyze health related quality of life after a hospital episode for patients with community acquired pneumococcal pneumonia in France. METHODS: A total of 524 individuals were enrolled prospectively in the study and were followed for 12 months after hospital discharge. Presence of streptococcus pneumoniae was confirmed by microbiological sampling. Quality of life was reported at four different points of time with the EQ-5D-3 L health states using the French reference tariff. Complete data on all four periods was available for 269 patients. We used descriptive and econometric analysis to assess quality of life over time during follow-up, and to identify factors that impact the utility indexes and their evolution through time. We used Tobit panel data estimators to deal with the bounded nature of utility values. RESULTS: Average age of patients was 63 and 55% of patients were men. Negative predictors of quality of life were the severity of the initial event, history of pneumonia, smokers, age and being male. On average, quality of life improved in the first 6 months after discharge and stabilized beyond. At month 1, mean utility index was 0.53 (SD: 0.34) for men and 0.45 (SD: 0.34) for women, versus mean of 0.69 (SD: 0.33) and 0.70 (SD: 0.35) at Month 12. "Usual activities" was the dimension the most impacted by the disease episode. Utilities for men were significantly higher than for women, although male patients were more severe. Individuals over 85 years old did not improve quality of life during follow-up, and quality of life did not improve or deteriorated for 34% of patients. We found that length of hospital stay was negatively correlated with quality of life immediately after discharge. CONCLUSION: This study provides with evidence that quality of life after an episode of community acquired pneumococcal pneumonia improves overall until the sixth month after hospital discharge, but older patients with previous history of pneumonia may not experience health gains after the initial episode.
