BACKGROUND:Antibiotic-resistant infections are known to pose a significant challenge to cancer patients, with increased morbidity, mortality and financial burden; however, less is known about their potential impact on health-related quality of life (HRQoL) in this population. This study aimed to assess HRQoL, its predictors, and quality-adjusted life years (QALYs) in cancer patients with antimicrobial-resistant infections (ARG) compared to those with antimicrobial-sensitive infections (ASG) and no infection.
METHODS:A prospective cohort observational study was conducted among (N = 657) hospitalized adult cancer patients categorized into three groups: no infection (n = 150), ASG (n = 159), and ARG (n = 348), for 18 months. HRQoL was assessed using the EQ-5D-5L tool.
RESULTS:Patients with ARG reported lower HRQoL, with a mean utility score of 0.391 and EQ-VAS score of 41.79, compared to ASG (0.468; 49.31) and no infection (0.533; 55.39) (P < 0.001). However, multidrug-resistant (MDR) and extensively drug-resistant (XDR) groups demonstrated significantly lower HRQoL scores (utility: 0.417 & 0.372; EQ-VAS: 44.3 & 40.02) than ASG. QALYs declined progressively (no infection: 0.046, sensitive: 0.036, resistant: 0.025; p < 0.001). MDR & XDR infections were associated with the lowest QALYs (0.028 & 0.022). Predictors identified that contributed to poorer HRQoL included age >60 years (β = -0.102), Length of stay (β = -0.019), Rural residence (β = -0.006), Stage IV of cancer (β = -0.014), Bloodstream infection (β = -0.038), and Urinary tract infections (β = -0.052), Use of Invasive devices (β = -0.055), Pneumonia (β = -0.137) and Sepsis (β = -0.274).
CONCLUSION:Antimicrobial-resistant infections significantly impact HRQoL and QALYs in cancer patients compared with those with antimicrobial-sensitive infections and those without infections.