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Abstract: TH-PO594

Patterns of Acute Care Utilization and Health-Related Quality of Life in Primary Glomerulonephropathy Patients

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Yang, Chien-Wen, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Liu, Qian, The Children's Hospital of Philadelphia Research Institute, Philadelphia, Pennsylvania, United States
  • Glenn, Dorey A., The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States
  • Denburg, Michelle, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
  • Zee, Jarcy, University of Pennsylvania, Philadelphia, Pennsylvania, United States
Background

The relationship between acute care utilization and health-related quality of life (HRQOL) in patients with GN is unclear. We hypothesize that the number of acute care events (ACE) will be associated with worse HRQOL among adults and children in CureGN.

Methods

CureGN is a prospective observational cohort of primary GN including minimal change disease, IgA nephropathy/vasculitis, focal segmental glomerulosclerosis, and membranous nephropathy. Linear mixed effect models were used to explore the association between HRQOL and the number of ACE (hospitalizations and emergency room visits) within the prior 3 months. HRQOL was self-reported for adults and children ≥8 years old and reported by parent proxy for children <11 using the PROMIS instrument. Models were adjusted for potential confounders, including HRQOL measures before the 3-month ACE period, comorbidities, socioeconomic factors, and medication exposure.

Results

Among 2393 patients, 1282 experienced at least one ACE with an incidence of 75 events per 100 person-years. Infection, gastrointestinal and cardiovascular events were the most common diagnoses (15, 9, and 6 events per 100 person-years, respectively). Among adults and children ≥8, a greater number of ACE was associated with worse fatigue (p<0.001), general physical health (p<0.001), mobility (p=0.001), and global health (p=0.005). Among proxy-reported PROMIS measures, a greater number of ACE was associated with worse fatigue (p=0.001), mobility (p<0.001), and global health (p<0.001).

Conclusion

Having more ACE was associated with worse HRQOL in several physical health domains among patients with GN. Our study reinforces the healthcare burden of GN and helps identify risk factors for deterioration in the patient experience.

Funding

  • Other NIH Support