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Differential changes in quality of life components over 5 years in chronic obstructive pulmonary disease patients.

Nagai K, Makita H, Suzuki M, Shimizu K, Konno S, Ito YM, Nishimura M, Hokkaido COPD Cohort Study Investigato - Int J Chron Obstruct Pulmon Dis (2015)

Bottom Line: In contrast, the symptom component improved significantly year by year in the sustainers (>75 percentile), and it did not deteriorate even in the rapid decliners.Of the follow-up data, AFEV1/year was the best predictor for worsening of the components of SGRQ.The longitudinal changes of quality of life and their determinants are markedly different and independent between its components.

View Article: PubMed Central - PubMed

Affiliation: First Department of Medicine, Hokkaido University School of Medicine, Sapporo, Japan.

ABSTRACT

Background: The aim of the study was to examine the longitudinal change in quality of life components of patients with chronic obstructive pulmonary disease (COPD).

Methods: In the Hokkaido COPD Cohort Study, 261 subjects were appropriately treated and followed over 5 years with a 74% follow-up rate at the end. The longitudinal changes in St George's Respiratory Questionnaire (SGRQ) scores were annually evaluated with forced expiratory volume in 1 second (FEV1). The subjects were classified into the rapid decliners, slow decliners, and sustainers based on AFEV1/year.

Results: The activity component of SGRQ generally deteriorated over time, and its annual decline was the greatest in the rapid decliners (<25th percentile). In contrast, the symptom component improved significantly year by year in the sustainers (>75 percentile), and it did not deteriorate even in the rapid decliners. Of the baseline data, predictors for worsening of the activity component were older age and lower body mass index. Larger reversibility was related to symptom component improvement. Of the follow-up data, AFEV1/year was the best predictor for worsening of the components of SGRQ. Continuous smoking was another factor for worsening of the activity component. For the symptom component, a history of exacerbation by admission definition was the determinant of its deterioration, whereas use of beta agonists was related to improvement.

Conclusion: The longitudinal changes of quality of life and their determinants are markedly different and independent between its components. The activity component of SGRQ generally deteriorated over years, while the symptom component rather improved in some patients with COPD under appropriate treatment.

No MeSH data available.


Related in: MedlinePlus

The changes in the total and three component scores of the SGRQ during follow-up.Notes: Annual changes in the total score of SGRQ from baseline classified by annual change in FEV1 (ml/year) during follow-up; The change from baseline in the SGRQ total score (mean ΔSGRQ ± SE) at 4-year follow-up: ΔSGRQ in rapid FEV1 decliners, 5±2; slow FEV1 decliners, 0±1, or FEV1 sustainers, −4±2, and at 5-year follow-up: ΔSGRQ in rapid FEV1 decliners, 5±2; slow FEV1 decliners, 0±1; or FEV1 sustainers, −4±2 (A). Annual changes in the activity scores (B), symptom scores (C), and impact scores (D) of the SGRQ classified by annual change in postbronchodilator FEV1 (ml/year) during follow-up are shown. P-values represent one-way analysis of variance with post hoc comparisons using Tukey’s multiple comparison tests at each year.Abbreviations: FEV1, forced expiratory volume in 1 second; SGRQ, St George’s Respiratory Questionnaire; ΔSGRQ, change from baseline in the SGRQ; SE, standard error.
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f3-copd-10-745: The changes in the total and three component scores of the SGRQ during follow-up.Notes: Annual changes in the total score of SGRQ from baseline classified by annual change in FEV1 (ml/year) during follow-up; The change from baseline in the SGRQ total score (mean ΔSGRQ ± SE) at 4-year follow-up: ΔSGRQ in rapid FEV1 decliners, 5±2; slow FEV1 decliners, 0±1, or FEV1 sustainers, −4±2, and at 5-year follow-up: ΔSGRQ in rapid FEV1 decliners, 5±2; slow FEV1 decliners, 0±1; or FEV1 sustainers, −4±2 (A). Annual changes in the activity scores (B), symptom scores (C), and impact scores (D) of the SGRQ classified by annual change in postbronchodilator FEV1 (ml/year) during follow-up are shown. P-values represent one-way analysis of variance with post hoc comparisons using Tukey’s multiple comparison tests at each year.Abbreviations: FEV1, forced expiratory volume in 1 second; SGRQ, St George’s Respiratory Questionnaire; ΔSGRQ, change from baseline in the SGRQ; SE, standard error.

Mentions: The changes from baseline in the SGRQ scores at each year were compared among the three groups classified by annualized ΔFEV1. The change from baseline in the SGRQ total score demonstrated clinically significant deterioration in rapid FEV decliners, whereas there was clinically significant improvement in FEV1 sustainers at 4-year follow-up (rapid FEV1 decliners ΔSGRQ 5±2, slow FEV1 decliners 0±1, FEV1 sustainers −4±2) and at 5-year follow-up (rapid FEV1 decliners ΔSGRQ 5±2, slow FEV1 decliners 0±1, FEV1 sustainers −4±2) (Figure 3A). Significant differences were noted between the changes in rapid FEV1 decliners and FEV sustainers at both 4-year and 5-year follow-ups (P<0.001 for both). The SGRQ activity score deteriorated significantly in rapid FEV1 decliners relative to slow FEV1 decliners and FEV1 sustainers at both 4-year follow-up (P=0.016, P=0.023, respectively) and 5-year follow-up (P=0.005, P<0.001, respectively) (Figure 3B). The SGRQ symptom score improved more in FEV1 sustainers than in rapid FEV1 decliners at 4 years (P=0.001) and at 5 years (P=0.023) (Figure 3C). At 5-year follow-up, the SGRQ impact score was significantly better in FEV sustainers than in rapid FEV decliners (P=0.005) and slow FEV1 decliners (P=0.038) (Figure 3D).


Differential changes in quality of life components over 5 years in chronic obstructive pulmonary disease patients.

Nagai K, Makita H, Suzuki M, Shimizu K, Konno S, Ito YM, Nishimura M, Hokkaido COPD Cohort Study Investigato - Int J Chron Obstruct Pulmon Dis (2015)

The changes in the total and three component scores of the SGRQ during follow-up.Notes: Annual changes in the total score of SGRQ from baseline classified by annual change in FEV1 (ml/year) during follow-up; The change from baseline in the SGRQ total score (mean ΔSGRQ ± SE) at 4-year follow-up: ΔSGRQ in rapid FEV1 decliners, 5±2; slow FEV1 decliners, 0±1, or FEV1 sustainers, −4±2, and at 5-year follow-up: ΔSGRQ in rapid FEV1 decliners, 5±2; slow FEV1 decliners, 0±1; or FEV1 sustainers, −4±2 (A). Annual changes in the activity scores (B), symptom scores (C), and impact scores (D) of the SGRQ classified by annual change in postbronchodilator FEV1 (ml/year) during follow-up are shown. P-values represent one-way analysis of variance with post hoc comparisons using Tukey’s multiple comparison tests at each year.Abbreviations: FEV1, forced expiratory volume in 1 second; SGRQ, St George’s Respiratory Questionnaire; ΔSGRQ, change from baseline in the SGRQ; SE, standard error.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4401330&req=5

f3-copd-10-745: The changes in the total and three component scores of the SGRQ during follow-up.Notes: Annual changes in the total score of SGRQ from baseline classified by annual change in FEV1 (ml/year) during follow-up; The change from baseline in the SGRQ total score (mean ΔSGRQ ± SE) at 4-year follow-up: ΔSGRQ in rapid FEV1 decliners, 5±2; slow FEV1 decliners, 0±1, or FEV1 sustainers, −4±2, and at 5-year follow-up: ΔSGRQ in rapid FEV1 decliners, 5±2; slow FEV1 decliners, 0±1; or FEV1 sustainers, −4±2 (A). Annual changes in the activity scores (B), symptom scores (C), and impact scores (D) of the SGRQ classified by annual change in postbronchodilator FEV1 (ml/year) during follow-up are shown. P-values represent one-way analysis of variance with post hoc comparisons using Tukey’s multiple comparison tests at each year.Abbreviations: FEV1, forced expiratory volume in 1 second; SGRQ, St George’s Respiratory Questionnaire; ΔSGRQ, change from baseline in the SGRQ; SE, standard error.
Mentions: The changes from baseline in the SGRQ scores at each year were compared among the three groups classified by annualized ΔFEV1. The change from baseline in the SGRQ total score demonstrated clinically significant deterioration in rapid FEV decliners, whereas there was clinically significant improvement in FEV1 sustainers at 4-year follow-up (rapid FEV1 decliners ΔSGRQ 5±2, slow FEV1 decliners 0±1, FEV1 sustainers −4±2) and at 5-year follow-up (rapid FEV1 decliners ΔSGRQ 5±2, slow FEV1 decliners 0±1, FEV1 sustainers −4±2) (Figure 3A). Significant differences were noted between the changes in rapid FEV1 decliners and FEV sustainers at both 4-year and 5-year follow-ups (P<0.001 for both). The SGRQ activity score deteriorated significantly in rapid FEV1 decliners relative to slow FEV1 decliners and FEV1 sustainers at both 4-year follow-up (P=0.016, P=0.023, respectively) and 5-year follow-up (P=0.005, P<0.001, respectively) (Figure 3B). The SGRQ symptom score improved more in FEV1 sustainers than in rapid FEV1 decliners at 4 years (P=0.001) and at 5 years (P=0.023) (Figure 3C). At 5-year follow-up, the SGRQ impact score was significantly better in FEV sustainers than in rapid FEV decliners (P=0.005) and slow FEV1 decliners (P=0.038) (Figure 3D).

Bottom Line: In contrast, the symptom component improved significantly year by year in the sustainers (>75 percentile), and it did not deteriorate even in the rapid decliners.Of the follow-up data, AFEV1/year was the best predictor for worsening of the components of SGRQ.The longitudinal changes of quality of life and their determinants are markedly different and independent between its components.

View Article: PubMed Central - PubMed

Affiliation: First Department of Medicine, Hokkaido University School of Medicine, Sapporo, Japan.

ABSTRACT

Background: The aim of the study was to examine the longitudinal change in quality of life components of patients with chronic obstructive pulmonary disease (COPD).

Methods: In the Hokkaido COPD Cohort Study, 261 subjects were appropriately treated and followed over 5 years with a 74% follow-up rate at the end. The longitudinal changes in St George's Respiratory Questionnaire (SGRQ) scores were annually evaluated with forced expiratory volume in 1 second (FEV1). The subjects were classified into the rapid decliners, slow decliners, and sustainers based on AFEV1/year.

Results: The activity component of SGRQ generally deteriorated over time, and its annual decline was the greatest in the rapid decliners (<25th percentile). In contrast, the symptom component improved significantly year by year in the sustainers (>75 percentile), and it did not deteriorate even in the rapid decliners. Of the baseline data, predictors for worsening of the activity component were older age and lower body mass index. Larger reversibility was related to symptom component improvement. Of the follow-up data, AFEV1/year was the best predictor for worsening of the components of SGRQ. Continuous smoking was another factor for worsening of the activity component. For the symptom component, a history of exacerbation by admission definition was the determinant of its deterioration, whereas use of beta agonists was related to improvement.

Conclusion: The longitudinal changes of quality of life and their determinants are markedly different and independent between its components. The activity component of SGRQ generally deteriorated over years, while the symptom component rather improved in some patients with COPD under appropriate treatment.

No MeSH data available.


Related in: MedlinePlus