In:
BMC Pulmonary Medicine, Springer Science and Business Media LLC, Vol. 20, No. 1 ( 2020-12)
Kurzfassung:
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.
Materialart:
Online-Ressource
ISSN:
1471-2466
DOI:
10.1186/s12890-020-1147-5
Sprache:
Englisch
Verlag:
Springer Science and Business Media LLC
Publikationsdatum:
2020
ZDB Id:
2059871-3
