Health-related quality of life associates with change in FEV 1 in COPD: results from the COSYCONET cohort.

Autor: Lutter JI; Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, GmbH - German Research Center for Environmental Health, Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Ingolstaedter Landstr. 1, 85764, Neuherberg, Germany. johanna.lutter@helmholtz-muenchen.de., Jörres RA; Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Ziemssenstr. 1, 80336, Munich, Germany., Kahnert K; Department of Internal Medicine V, University of Munich (LMU), Comprehensive Pneumology Center, Member of the German Center for Lung Research, Ziemssenstr. 1, 80336, Munich, Germany., Schwarzkopf L; Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, GmbH - German Research Center for Environmental Health, Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Ingolstaedter Landstr. 1, 85764, Neuherberg, Germany., Studnicka M; Department of Pneumology, Paracelsus Medical University Salzburg, Universitätsklinikum Salzburg, Müllner Hauptstrasse 48, 5020, Salzburg, Austria., Karrasch S; Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Ziemssenstr. 1, 80336, Munich, Germany.; Institute of Epidemiology, Helmholtz Zentrum München (GmbH) - German Research Center for Environmental Health, Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Ingolstaedter Landstr. 1, 85764, Neuherberg, Germany.; Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, Member of the German Center for Lung Research (DZL), Baldingerstrasse, 35043, Marburg, Germany., Schulz H; Institute of Epidemiology, Helmholtz Zentrum München (GmbH) - German Research Center for Environmental Health, Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Ingolstaedter Landstr. 1, 85764, Neuherberg, Germany., Vogelmeier CF; Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, Member of the German Center for Lung Research (DZL), Baldingerstrasse, 35043, Marburg, Germany., Holle R; Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, GmbH - German Research Center for Environmental Health, Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Ingolstaedter Landstr. 1, 85764, Neuherberg, Germany.; Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Ludwig-Maximilians-University Munich (LMU), Marchioninistr. 15, 81377, Munich, Germany.
Jazyk: angličtina
Zdroj: BMC pulmonary medicine [BMC Pulm Med] 2020 May 29; Vol. 20 (1), pp. 148. Date of Electronic Publication: 2020 May 29.
DOI: 10.1186/s12890-020-1147-5
Abstrakt: Background: Forced expiratory volume in one second (FEV 1 ) characterizes the pathophysiology of COPD and different trajectories of FEV 1 decline have been observed in patients with COPD (e.g. gradual or episodic). There is limited information about the development of patient-reported health-related quality of life (HRQL) over the full range of the natural history of COPD. We examined the longitudinal association between change in FEV 1 and change in disease-specific and generic HRQL.
Methods: We analysed data of 1734 patients with COPD participating in the COSYCONET cohort with up to 3 years of follow-up. Patients completed the Saint George's Respiratory Questionnaire (SGRQ) and the EQ-5D Visual Analog Scale (EQ VAS). Change score models were used to investigate the relationship between HRQL and FEV 1 and to calculate mean changes in HRQL per FEV 1 change categories [decrease (≤ - 100 ml), no change, increase (≥ 100 ml)] after 3 years. Applying hierarchical linear models (HLM), we estimated the cross-sectional between-subject difference and the longitudinal within-subject change of HRQL as related to a FEV 1 difference or change.
Results: We observed a statistically significant deterioration in SGRQ (total score + 1.3 units) after 3 years, which was completely driven by the activity component (+ 4 units). No significant change was found for the generic EQ VAS. Over the same period, 58% of patients experienced a decrease in FEV 1 , 28% were recorded as no change in FEV 1 , and 13% experienced an increase. The relationship between HRQL and FEV 1 was found to be approximately linear with decrease in FEV 1 being statistically significantly associated with a deterioration in SGRQ (+ 3.20 units). Increase in FEV 1 was associated with improvements in SGRQ (- 3.81 units). The associations between change in FEV 1 and the EQ VAS were similar. Results of the HLMs were consistent and highly statistically significant, indicating cross-sectional and longitudinal associations. The largest estimates were found for the association between FEV 1 and the SGRQ activity domain.
Conclusions: Difference and change in FEV 1 over time correlate with difference and change in disease-specific and generic HRQL. We conclude, that deterioration of HRQL should induce timely re-examination of physical status and lung function and possibly reassessment of therapeutic regimes.
Trial Registration: NCT01245933. Date of registration: 18 November 2010.
Databáze: MEDLINE
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