Adaptation and Psychometric Validation of the Arabic EuroQol-5D-5L among Sepsis Survivors in Saudi Arabia.

BACKGROUND

Sepsis significantly impairs long-term health-related quality of life (HRQoL). The EuroQol-5D-5 L (EQ-5D-5L) is a validated tool for measuring HRQoL in acute illness; however, there is no validated Arabic version for sepsis survivors. This study aimed to validate an Arabic version of the EQ-5D-5L in sepsis survivors.

METHODS

We conducted a cross-sectional validation study between 2024 and 2025 at Prince Sultan Military Medical City in Riyadh, Saudi Arabia. We recruited sepsis survivors aged ≥ 18 years who agreed to participate in this study. Four bilingual translators performed forward and backward translation of the EQ-5D-5L. Research coordinators conducted phone interviews with participants or their caregivers and administered the Arabic EQ-5D-5L instrument twice, at baseline and at two weeks, and a validated Arabic version of the SF-36 Health Survey. All patients completed the test-retest assessment. We assessed convergent validity by measuring the correlation between conceptually related domains of EQ-5D-5L and SF-36 questionnaires. We measured intraclass correlation coefficients (ICC) to assess test-retest reliability.

RESULTS

Fifty-five sepsis survivors were recruited using a consecutive sampling method and consented to participate in the study. Participants had a median age of 62 years (interquartile range: 36–71), and 45.5% were male. Overall, 45 (81.8%) participants had sepsis, while 10 (18.2%) had septic shock. The median EQ-5D index score was 0.63 (IQR: 0.14–0.96), and the median visual analogue scale score for quality of life was 60 (IQR: 50–80). The Arabic EQ-5D-5L demonstrated a strong correlation between the EQ-5D-5L index and SF-36 Physical Component Summary (Spearman’s Rho = 0.83, P < 0.001) and Mental Component Summary (Rho = 0.84, P < 0.001). Convergent validity was confirmed through strong correlations between conceptually related domains. Test-retest reliability showed an ICC ranging from 0.52 to 0.90 across domains.

CONCLUSIONS

The Arabic EQ-5D-5L shows strong psychometric properties and is a valid tool for assessing HRQoL among Arabic-speaking sepsis survivors. It can support clinical assessment, outcome tracking, and rehabilitation planning in this population.