Article

Persons with severe chronic obstructive pulmonary disease (COPD) and similar
levels of forced expiratory volume in 1 second (FEV(1)), exercise capacity, and
dyspnea have a wide range of health-related quality of life (HRQL). We identified
the independent determinants of HRQL in persons with COPD. Comprehensive
assessments of physiological, psychosocial, and clinical variables from the
National Emphysema Treatment Trial were used. HRQL was assessed by the Medical
Outcomes Study 36-Item Short Form Physical Component Summary (PCS) and Mental
Component Summary (MCS) scores and the St. George's Respiratory Questionnaire
total score (SGRQ-TS). In multivariate linear regression models, exercise
capacity, dyspnea, age, single-breath diffusing capacity of the lung for carbon
monoxide percent predicted, and self-report of being disabled were significant
determinants of PCS score. Dyspnea, depression, antidepressant use, daytime
sleepiness, and education were significant determinants of MCS score. Prior
participation in pulmonary rehabilitation, supplemental oxygen use, and oral
corticosteroid use were significant determinants of SGRQ-TS. Although FEV(1),
6-minute walk test distance, and dyspnea significantly correlated with HRQL,
their effects on HRQL were reduced when other variables were considered. Greater
exercise capacity, prior participation in pulmonary rehabilitation, and use of
supplemental oxygen were significantly associated with better HRQL.
Self-perception of being disabled, (Abstract continued) depression, dyspnea, oral
corticosteroid use, and daytime sleepiness were associated with worse HRQL. To
optimize HRQL, clinicians should pay attention to a number of clinical and
physiological factors.

Langue : ANGLAIS