title: Systemic lupus erythematosus in a multiethnic lupus cohort (LUMINA). XVII. Predictors of self-reported health-related quality of life early in the disease course.
abstract: OBJECTIVE
  To determine the baseline factors predictive of self-reported health-related quality of life (HRQOL) early in the course of systemic lupus erythematosus patients (SLE) from a multiethnic LUMINA (Lupus in Minorities: Nature versus nurture) cohort.
  
  
  METHODS
  LUMINA patients with > or =2 visits were studied. Self-reported HRQOL was examined with the 8 subscales and 2 summary measures (the Physical Component Summary [PCS], and the Mental Component Summary [MCS]) of the Short Form 36 (SF-36). Bivariable and multivariable analyses were done with the PCS, MCS and 8 subscales as the dependent variables. The analyses were performed including and excluding the corresponding SF-36 measure from the independent variables. Age, sex, and ethnicity were included in all models. Time was modeled in all regressions.
  
  
  RESULTS
  A total of 1,351 visits (346 patients [80 Hispanics-Texas, 34 Hispanics-Puerto Rico, 126 African Americans, and 106 Caucasians]) were included in these analyses. Mean +/- SD PCS and MCS scores were 36.7 +/- 12.0 and 46.6 +/- 11.5, respectively. The scores for the eight subscales of the SF-36 were also lower than those for the general population. Baseline SF-36 measures were highly predictive of subsequent HRQOL. In the same set of regressions, older age was found to consistently predict poor self-reported HRQOL whereas fibromyalgia, helplessness, fatigue, and abnormal illness-related behaviors were also predictive, but less consistently. Estimated adjusted variances in these regressions ranged from 23% (Role-Emotional [RE]) to 43% (Physical Functioning [PF]).
  
  
  CONCLUSIONS
  In patients with SLE, poor baseline HRQOL was highly predictive of subsequent poor HRQOL. Other predictive variables of poor functioning were primarily psychological/behavioral and socioeconomic-demographic.
authors.affiliation: The University of Alabama at Birmingham.
authors.forename: Graciela S
authors.initials: GS
authors.lastname: Alarcón
authors.forename: Gerald
authors.initials: G
authors.lastname: McGwin
authors.forename: América
authors.initials: A
authors.lastname: Uribe
authors.forename: Alan W
authors.initials: AW
authors.lastname: Friedman
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Roseman
authors.forename: Barri J
authors.initials: BJ
authors.lastname: Fessler
authors.forename: Holly M
authors.initials: HM
authors.lastname: Bastian
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Baethge
authors.forename: Luis M
authors.initials: LM
authors.lastname: Vilá
authors.forename: John D
authors.initials: JD
authors.lastname: Reveille
mesh_terms: D000328:Adult; D001741:Black or African American; D001519:Behavior; D015331:Cohort Studies; D003710:Demography; D005260:Female; D006304:Health Status; D006630:Hispanic or Latino; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000208:ethnology / Q000503:physiopathology* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011788:Quality of Life; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D044465:White People