Are health-related quality-of-life and self-rated health associated with mortality? Insights from Translating Research Into Action for Diabetes (TRIAD)

McEwen, Laura N.; Kim, Catherine; Haan, Mary N.; Ghosh, Debashis; Lantz, Paula M.; Thompson, Theodore J.; Herman, William H.

doi:10.1016/j.pcd.2009.01.001

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Volume 3, Issue 1 , Pages 37-42, February 2009

Are health-related quality-of-life and self-rated health associated with mortality? Insights from Translating Research Into Action for Diabetes (TRIAD)

Laura N. McEwen
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, United States
- Corresponding author at: Internal Medicine TRIAD, P.O. Box 131337, Ann Arbor, MI 48113, United States. Tel.: +1 734 998 6978; fax: +1 734 998 7136.
Catherine Kim
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, United States
Mary N. Haan
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, United States
Debashis Ghosh
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States
Paula M. Lantz
- Department of Health Management and Policy, University of Michigan, Ann Arbor, MI, United States
Theodore J. Thompson
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, United States
William H. Herman
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, United States

Received 20 August 2008; received in revised form 22 January 2009; accepted 28 January 2009. published online 09 March 2009.

Abstract

Aims

To determine if health-related quality-of-life and self-rated health are associated with mortality in persons with diabetes.

Methods

Survey and medical record data were obtained from 7892 patients with diabetes in Translating Research Into Action for Diabetes (TRIAD), a multicenter prospective observational study of diabetes care in managed care. Vital status at follow-up was determined from the National Death Index. Multivariable proportional hazard models were used to determine if a generic measure of health-related quality-of-life (EQ-5D) and self-rated health measured at baseline were associated with 4-year all-cause, cardiovascular, and noncardiovascular mortality.

Results

At baseline, the mean EQ-5D score for decedents was 0.73 (S.D.=0.20) and for survivors was 0.81 (S.D.=0.18) (p<0.0001). Fifty-five percent of decedents and 36% of survivors (p<0.0001) rated their health as fair or poor. Lower EQ-5D scores and fair or poor self-rated health were associated with higher rates of mortality after adjusting for the demographic, socioeconomic, and clinical risk factors for mortality.

Conclusions

Health-related quality-of-life and self-rated health predict mortality in persons with diabetes. Health-related quality-of-life and self-rated health may provide additional information on patient risk independent of demographic, socioeconomic, and clinical risk factors for mortality.

Abbreviations: BMI, body mass index, CI, confidence interval, HR, hazard rate ratio, HRQoL, health-related quality-of-life, ICD-10, International Classification of Diseases—10th revision, NDI, National Death Index, TRIAD, Translating Research Into Action for Diabetes