腦中風之健康人日損失評估

Measuring Days of Healthy Life Lost (DULL) in Stroke Patients

楊慎絢(Sun-Shen Yang)

《北市醫學雜誌》 1卷4期 (2004/10) Pp. 444-450

https://doi.org/10.6200/TCMJ.2004.1.4.09

摘要

目的：健康相關生命品質（HROL）與生命品質人年（OALY）已逐漸用於臨床決策分析。如果能以健康相關生命品質（HROL）的觀念來估算腦中風急慢性期的健康人日損失（DHLL），則更能反應其健康衝擊。方法：以忠孝醫院急性腦中風病人為對象，測量 HROL 評價等級，得有效樣本38位。同時抽樣慢性期病患，得有效樣本20位，並取同時段59位健檢老人為對照組。結果：腦中風初發者的HROL評價等級顯著低於健檢老人與慢性期病患。HROL評價等級隨ADL的增加，成一致的遞減。將腦中風急慢性期的日ROL代入GHAPT的架構，推估出腦中風發病一生內的DHLL為239.8日，換算QALY為0.66年。結論：HROL評價等級可用於腦中風急慢性期的測量。本研究發展的效用等級，可初步用於評估腦中風病患的DHLL。

關鍵字

健康相關生命品質 ； 生命品質人年 ； 健康人日損失 ； 日常生活活動 ； 腦中風

並列摘要

Objective: Health related quality of life (HRQL) and quality adjusted life years (QALY) has been applied in clinical decision making and health policy planning. The HRQL concept was utilized for measuring the DHLL for both acute and chronic stroke patients. Methods: During the study period, stroke patients were regular visitors to Chung-Hsiao hospital based cohort. The utility scales were applied to measure HRQL of 38 patients with acute stroke, 20 patients with chronic stroke, and 59 healthy elders. Results: The decrease in HRQL of stroke patients was associated　with the extent of decrease in activities of daily living (ADL). By applying the Ghana Health Assessment Project Team (GHAPT) model into the HRQL of stroke patents, it estimated 239.8 days of DHLL and 0.66 years of QALY for the first year of stroke patients. Conclusion: HRQL is a valuable tool for assessing stroke patients in the acute and chronic stage. Further study using survival adjusted quality of life may lead to further insight into the effect of stroke in both the acute and chronic stage. (Full text in Chinese)

並列關鍵字

health related quality of life ； quality adjusted life year ； days of healthy life lost ； activities of daily living ； stroke