title: Relationship between flare and health-related quality of life in patients with systemic lupus erythematosus.
abstract: OBJECTIVE
  To investigate (1) the relationship between flares and health-related quality of life (HRQOL) in Chinese patients with systemic lupus erythematosus (SLE) in Hong Kong; and (2) the influence of severity of flare, number of organs involved in flares, and manifestations of flares on HRQOL.
  
  
  METHODS
  A retrospective study was performed on 303 patients with SLE. Participants completed the Medical Outcomes Survey Short-Form 36 (SF-36) and underwent clinical and laboratory examination to evaluate disease activity and damage. The total number and manifestations of flares during the preceding year were assessed retrospectively. Multiple linear regression analysis was used to identify the independent variables associated with impairment of HRQOL.
  
  
  RESULTS
  Patients with flares were younger, had a shorter disease duration, and had higher disease activity at the time of the assessment. A total of 72 episodes of flares were recorded in 61 patients in the preceding year. Patients with flares had significantly lower scores in the areas of role limitation due to physical problems, general health, social function, and role limitation due to emotional problems compared with those without flare. The physical health summary scale was also lower in patients with flares. In the multivariate analysis, the presence of musculoskeletal flare was independently associated with all scales of the SF-36, except bodily pain and mental health.
  
  
  CONCLUSIONS
  The low level of patients' HRQOL is mostly associated with the presence of musculoskeletal involvement.
authors.affiliation: Department of Medicine and Therapeutics, The Prince of Wales Hospital, New Territory, Hong Kong, China.
authors.forename: Tracy Y
authors.initials: TY
authors.lastname: Zhu
authors.forename: Lai-Shan
authors.initials: LS
authors.lastname: Tam
authors.forename: Vivian W Y
authors.initials: VW
authors.lastname: Lee
authors.forename: Kenneth K
authors.initials: KK
authors.lastname: Lee
authors.forename: Edmund K
authors.initials: EK
authors.lastname: Li
mesh_terms: D000328:Adult; D005260:Female; D006306:Health Surveys; D006723:Hong Kong; D006801:Humans; D016014:Linear Models; D008180:Lupus Erythematosus, Systemic / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009141:Musculoskeletal System / Q000503:physiopathology; D011788:Quality of Life; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index