Emphysema severity linked to HRQoL in elderly COPD patients
MedWire News: The severity of emphysema, but not that of airway narrowing, is significantly associated with generic and health-related quality of life (HRQoL) in elderly patients with chronic obstructive pulmonary disease (COPD), researchers have found.
Kozui Kida, from Nippon Medical School in Tokyo, Japan, and team explain: “The effects of pathological emphysema on gas exchange and airway narrowing on airflow limitation have been well-documented; however, studies on the effects of these structural alterations in the lungs of [elderly] COPD patients on both generic and HRQoL are limited.”
To address this, the researchers studied 125 elderly COPD patients (111 men and 14 women) and who were aged an average of 71 years and had a lifetime history of smoking. Of these, eight had stage I, 47 had stage II, 50 had stage III, and 20 had stage IV COPD.
All the participants underwent high-resolution computed tomography (HRCT) scans to assess emphysema severity, expressed as the percentage of the lung occupied by low-attenuation area (LAA%), and airway narrowing, expressed as percentage of the affected large airway wall area (WA%).
They also underwent exercise and lung function tests, and completed various measures of generic and HRQoL, including the Japanese version of the Short-Form 36-Item Health Study and the Japanese version of St George's Respiratory Questionnaire (SGRQ).
The researchers found that both LAA% and WA% significantly correlated with FEV1 percentage predicted, although the correlation was stronger with LAA% than WA%.
The total SGRQ score positively and significantly correlated with LAA%, and the SF-36 score also showed a correlation in this regard. However, total SGRQ and SF-36 scores did not correlate with WA%.
Writing in the journal Geriatrics and Gerontology International, Kida and team conclude that “the severity of emphysema, but not that of large airway narrowing on HRCT, is associated with both generic and health-related QOL and reduced diffusion capacity.”
They add: “This notion might provide useful information in practice among elderly subjects who are unable to perform a spirometry test.”
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By Mark Cowen