Quality of life and urolithiasis: the patient - reported outcomes measurement information system (PROMIS)

ABSTRACT Background: With a high rate of recurrence, urolithiasis is a chronic disease that impacts quality of life. The Patient Reported Outcomes Measurement Information System is an NIH validated questionnaire to assess patient quality of life. We evaluated the impact of urolithiasis on quality of life using the NIH-sponsored PROMIS-43 questionnaire. Materials and Methods: Patients reporting to the kidney stone clinic were interviewed to collect information on stone history and demographic information and were asked to complete the PROMIS-43 questionnaire. Quality of life scores were analyzed using gender and age matched groups for the general US population. Statistical comparisons were made based on demographic information and patient stone history. Statistical significance was P<0.05. Results: 103 patients completed the survey. 36% of respondents were male, the average age of the group was 52 years old, with 58% primary income earners, and 35% primary caregivers. 7% had never passed a stone or had a procedure while 17% passed 10 or more stones in their lifetime. Overall, pain and physical function were worse in patients with urolithiasis. Primary income earners had better quality of life while primary caregivers and those with other chronic medical conditions were worse. Patients on dietary and medical therapy had better quality of life scores. Conclusions: Urolithiasis patients subjectively have worse pain and physical function than the general population. The impact of pain on quality of life was greatest in those patients who had more stone episodes, underscoring the importance of preventive measures. Stone prevention measures improve quality of life.

摘要
背景：尿路结石症（urolithiasis）复发率居高不下，属于影响患者生活质量的慢性疾病。患者报告结局测量信息系统（Patient Reported Outcomes Measurement Information System，PROMIS）是美国国立卫生研究院（National Institutes of Health，NIH）验证通过的患者生活质量评估问卷。本研究依托美国国立卫生研究院资助的PROMIS-43问卷，评估尿路结石症对患者生活质量的影响。

材料与方法：对前往肾结石门诊就诊的患者开展访谈，收集其结石病史与人口统计学资料，并要求其完成PROMIS-43问卷。以美国普通人群的性别、年龄匹配组作为对照，分析患者的生活质量评分。基于人口统计学信息与患者结石病史进行统计学比较，检验水准设定为P<0.05。

结果：共计103例患者完成本次调查。其中36%为男性，研究人群平均年龄为52岁，58%为家庭主要收入来源者，35%为家庭主要照料者。7%的患者从未排出过结石或接受过相关手术，另有17%的患者一生中累计排出10枚及以上结石。整体而言，尿路结石症患者的疼痛症状与躯体功能状态更差。家庭主要收入来源者的生活质量更佳，而家庭主要照料者以及合并其他慢性疾病的患者生活质量更差。接受饮食干预与药物治疗的患者生活质量评分更高。

结论：相较于普通人群，尿路结石症患者主观报告的疼痛程度更重、躯体功能更差。疼痛对生活质量的影响在结石发作次数更多的患者中最为显著，凸显了结石预防措施的重要性。结石预防手段可有效改善患者的生活质量。