Co-morbidities are the key nominators of the health related quality of life in mild and moderate COPD

BMC Pulmonary Medicine

Tarja Laitinen²  Dirkje Postma³  Ari Lindqvist⁴  Marike Boezen³  Harri Sintonen⁵  Witold Mazur⁴  Henna Kupiainen²  Maritta Kilpeläinen²  Jukka Koskela¹ 

[1] Research Unit for Pulmonary Diseases, Helsinki University Central Hospital, Tukholmankatu 8C, PO Box 705, FI-00029 HUS Helsinki, Finland;Division of Medicine, Department of Pulmonary Diseases and Clinical Allergology, Turku University Hospital and University of Turku, Turku, Finland;University of Groningen, University Medical Center Groningen, GRIAC Research Institute, Groningen, The Netherlands;Clinical Research Unit for Pulmonary Diseases and Division of Pulmonology, Helsinki University Central Hospital, Helsinki, Finland;Department of Public Health, University of Helsinki, Helsinki, Finland

关键词: Mortality;    Co-morbidities;    AQ20;    15D;    COPD;    HRQoL;    Respiratory specific HRQoL;    Generic HRQoL;   

Others  :  1228335
DOI  :  10.1186/1471-2466-14-102

 received in 2014-05-23, accepted in 2014-06-10,  发布年份 2014

【 摘 要 】

Background

Co-morbidities are common in chronic obstructive pulmonary disease (COPD). We assessed the contribution of common co-morbidities on health related quality of life (HRQoL) among COPD patients.

Methods

Using both generic (15D) and respiratory-specific (AQ20) instruments, HRQoL was assessed in a hospital based COPD population (N = 739, 64% males, mean age 64 years, SD 7 years) in this observational study with inferential analysis. The prevalence of their co-morbidities was compared with those of 5000 population controls. The patients represented all severity stages of COPD and the patterns of common concomitant disorders differed between patients.

Results

Co-morbidities such as psychiatric conditions, alcohol abuse, cardiovascular diseases, and diabetes were more common among COPD patients than in age and gender matched controls. Psychiatric conditions and alcohol abuse were the strongest determinants of HRQoL in COPD and could be detected by both 15D (Odds Ratio 4.7 and 2.3 respectively) and AQ20 (OR 2.0 and 3.0) instruments. Compared to respiratory specific AQ20, generic 15D was more sensitive to the effects of comorbidities while AQ20 was slightly more sensitive for the low FEV₁. FEV₁ was a strong determinant of HRQoL only at more severe stages of disease (FEV₁ < 40% of predicted). Poor HRQoL also predicted death during the next five years.

Conclusions

The results suggest that co-morbidities may impair HRQoL at an early stage of the disease, while bronchial obstruction becomes a significant determinant of HRQoL only in severe COPD.

【 授权许可】

   
2014 Koskela et al.; licensee BioMed Central Ltd.

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