Are health-related quality-of-life and self-rated health associated with mortality? Insights from Translating Research Into Action for Diabetes (TRIAD).
OBJECTIVE
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.
McEwen
Laura N
LN
Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA. lmattei@med.umich.edu
Kim
Catherine
C
Haan
Mary N
MN
Ghosh
Debashis
D
Lantz
Paula M
PM
Thompson
Theodore J
TJ
Herman
William H
WH
D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality* / Q000523:psychology*; D003920:Diabetes Mellitus / Q000401:mortality* / Q000523:psychology* / Q000628:therapy; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors; D012649:Self Concept; D013997:Time Factors; D014481:United States