Reversible Bronchial Obstruction and Disease-Related Health Status in COPD

• Published in: Quality of life research Vol. 11; no. 6; pp. 517 - 525
• Main Authors: Incalzi, R A, Bellia, V, Maggi, S, Imperiale, C, Capparella, O, Pistelli, R, Grassi, V
• Format: Journal Article
• Language: English
• Published: Netherlands Kluwer Academic Publishers 01.09.2002; Springer Nature B.V
• Subjects: Affect; Aged; Airway Obstruction - etiology; Airway Obstruction - physiopathology; Airway Obstruction - psychology; Asthma; Body mass index; Bronchi; Bronchitis; Chronic obstructive pulmonary disease; Cognition; Confidence intervals; Diagnostic indices; Discriminant analysis; Female; Forced Expiratory Volume; Geriatrics; Health outcomes; Health Status; Humans; Italy - epidemiology; Male; Middle Aged; Older adults; Pulmonary Disease, Chronic Obstructive - complications; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulmonary Disease, Chronic Obstructive - psychology; Questionnaires; Regression analysis; Reproducibility of Results; Severity of Illness Index; Studies; Surveys and Questionnaires; Italy
• ISSN: 0962-9343; 1573-2649
• DOI: 10.1023/A:1016349530281

We aimed to assess whether partially reversible and fixed airway obstructions are associated with different health status profiles of chronic obstructive pulmonary disease (COPD) patients. We characterized health status profiles of outpatients over 64 years suffering from COPD with fixed (n = 181) or partially reversible obstruction (n = 95) and from chronic bronchitis with forced expiratory volume in the first second (FEV1) > 69% of that predicted (n = 109) on the basis of the Saint George Respiratory Questionnaire (SGRQ) and indexes assessing cognitive (Mini Mental State), affective (15-item Geriatric Depression Scale) and physical status (Index of Barthel, six-minute walking test) and quality of sleep (Index of disturbed sleep). The degree of group-specificity of health status profiles was assessed by discriminant analysis. The 54.1% of COPD patients with partially reversible obstruction were recognized to have a distinctive health status profile characterized by a moderate to severe impairment of all components ('Symptoms', 'Activity', 'Impacts') of the SGRQ and of select indexes of performance. According to logistic regression analysis, this health status profile was associated with FEV<46% of that predicted (odds ratio (OR): 1.6, 95% confidence interval (CI): 1.07-2.38), the use of at least three respiratory drugs (OR: 2.28, CI: 1.46-3.57) and living alone (OR: 2.01, 95% CI: 1.3-2.29). COPD patients with fixed obstruction had a very heterogeneous health status. Research is needed to verify whether the unfavorable health status profile typical of a subset of COPD patients is associated with a distinctive prognosis and can be improved by dedicated therapeutic interventions.