Perceived health of patients with common variable immunodeficiency – a cluster analysis

Abstract

Common variable immunodeficiency (CVID) is a complex disease with various influences on perceived health, which correlate with different outcomes, including new morbidity and mortality. Our hypothesis was that CVID patients fall into distinct clusters of perceived health which can inform care. Ward hierarchical cluster analysis and K-means cluster analysis were performed on data of 209 CVID patients to identify subgroups regarding their self-reported physical and mental health status, assessed by the physical (PCS) and mental component scores (MCS) of the Short Form-12 (SF-12). Four clusters of CVID-patients were identified. Cluster 1 was the largest cluster, characterized by a relatively high physical and mental health status (44·0%). In contrast, cluster 2 (21·1%) included patients with low physical and mental health status. Clusters 3 and 4 were mixed groups with high mental and low physical health (15·8%) and vice versa (19·1%). Significant differences between the clusters were found for patient-reported outcomes such as work ability and health literacy, but not for CVID-associated complications such as enteropathy, interstitial lung disease, granulomatosis, lymphadenopathy and autoimmune cytopenia or laboratory parameters such as immunoglobulin levels or B cell-based classification. The results suggest different subgroups of CVID patients with contrasting individual needs which, surprisingly, did not differ in clinical or laboratory characteristics. The main finding of this study is that patients with CVID fall into four distinct clusters according to perceived health, which are largely independent of CVID complications.

Positive psychological profiles based on perceived health clustering in patients with cardiovascular disease: a longitudinal study

“…In a sample of patients with common variable immunodeficiency, Bayrhuber et al found a four-group classification after clustering participants’ combined perceived mental and physical health scores on the SF-12. 36 Although a similar design to that used by Bayrhuber et al for clustering perceived health variables was followed in this study, the two-step cluster analysis used in the current study is considered to be a more advantageous procedure compared with hierarchical approaches. 48 In these previous studies, clusters representing better self-reported health status were positively associated with a better psychosocial outcome 37 and other relevant variables such as work ability and health literacy, 36 while the negative psychological profile identified in patients with CVD was associated with mortality.…”

“… 36 Although a similar design to that used by Bayrhuber et al for clustering perceived health variables was followed in this study, the two-step cluster analysis used in the current study is considered to be a more advantageous procedure compared with hierarchical approaches. 48 In these previous studies, clusters representing better self-reported health status were positively associated with a better psychosocial outcome 37 and other relevant variables such as work ability and health literacy, 36 while the negative psychological profile identified in patients with CVD was associated with mortality. 26 In the present study, the cluster representing higher self-reported mental and physical health was also associated with better SES and psychological outcomes, reinforcing the relevance of considering clusters derived from self-reported health status in patients with a chronic condition.…”

“… 35 Moreover, this classification can assist in the identification of specific needs in each group of patients and develop psychological interventions accordingly. 36 …”

Bronchoalveolar Lavage Fluid Reflects a TH1-CD21low B-Cell Interaction in CVID-Related Interstitial Lung Disease

“…This is frequently associated with the development of bronchiectasis over time (5). Additionally, around 50% of CVID patients have secondary noninfectious lymphoproliferative, autoimmune and inflammatory complications like autoimmune cytopenias, granulomatous disease, splenomegaly and lymphadenopathy, interstitial lung disease, enteropathy and hepatopathy (6) often contributing to a significantly reduced quality of life and increased morbidity and mortality (7)(8)(9)(10).…”