Background In order to assess adequately the success of treatment of patients with systemic lupus erythematosus (SLE), the patient's individual perception of his physical and mental health and degree of integration into the community is required. The most commonly used standardized quality of life questionnaire, involving physical, mental and social acpects, is The Medical Outcome Survey Short Form 36 (SF-36). The results regarding the correlation of activity index and degree of organ damage in SLE patients with quality of life have so far been contradictory.
Objectives Our aim was to evaluate the quality of life of SLE patients using the SF-36 questionnaire, and to establish the correlation of Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), organ damage index - SLICC/ACR Damage Index (SDI) with quality of life.
Methods The study enrolled 85 SLE patients aged 45.3±9.7 years on the average, out of which 78 (91.8%) women and 7 (8.2%) men, with average disease duration of 10.4±8.0 years, hospitalized at the Clinic of Rheumatology, “Niška Banja” Institute, in whom the diagnosis was made based on the revised 1997 ACR criteria. Disease activity was assessed using the SLEDAI questionnaire, organ damage using the SDI, and quality of life using the SF-36 questionnaire. The control group consisted of 30 healthy examinees. Both groups were homogenous as to the factors of gender and age.
Results Our results showed that there was significantly worse quality of life in all SF-36 domains in SLE patients compared to controls (p<0.001). The domain of physical functions in SLE patients had poorer results compared to mental functions (36.68 vs. 49.14), and average results were below 52% in all SF-36 domains. There were no significant differences in the values of all SF-36 domains between the group with lupus nephritis and those without it. The mean value of SLEDAI was 11.38±7.55, median was 8, minimum value 0 and maximum value 36. In the assessment of correlation between the SLEDAI and quality of life represented via the SF-36 questionnaire, we found only a negative correlation between limitations due to physical difficulties and SLEDAI (r=-0.216; p<0.05). The mean SDI value was 1.81±1.98, median 1, minimum value 0, maximum value 9. Our study demonstrated a negative correlation between all SF-36 domains and SDI (p<0.001 in most domains), with the exception of emotional status and SDI, where a correlation was not found.
Conclusions Quality of life of SLE patients measured by the SF-36 index was significantly worse compared to healthy individuals. There was no difference in quality of life in any of SF-36 domains between those with and without lupus nephritis. Quality of life measured by the SF-36 index was not correlated with disease activity measured by the SLEDAI in most of the domains. Poorer quality of life was associated with a higher SDI, except for the emotional status domain.
Disclosure of Interest None declared