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Health-related quality of life and long-term prognosis in chronic hypercapnic respiratory failure: a prospective survival analysis.
- Source :
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Respiratory research [Respir Res] 2007 Dec 17; Vol. 8, pp. 92. Date of Electronic Publication: 2007 Dec 17. - Publication Year :
- 2007
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Abstract
- Background: Health-related quality of life (HRQL) is considered as an important outcome parameter in patients with chronic diseases. This study aimed to assess the role of disease-specific HRQL for long-term survival in patients of different diagnoses with chronic hypercapnic respiratory failure (CHRF).<br />Methods: In a cohort of 231 stable patients (chronic obstructive pulmonary disease (COPD), n = 98; non-COPD (obesity-hypoventilation syndrome, restrictive disorders, neuromuscular disorders), n = 133) with CHRF and current home mechanical ventilation (HMV), HRQL was assessed by the disease-specific Severe Respiratory Insufficiency (SRI) questionnaire and its prognostic value was prospectively evaluated during a follow-up of 2-4 years, using univariate and multivariate regression analysis.<br />Results: HRQL was more impaired in COPD (mean +/- SD SRI-summary score (SRI-SS) 52.5 +/- 15.6) than non-COPD patients (67.6 +/- 16.4; p < 0.001). Overall mortality during 28.9 +/- 8.8 months of follow-up was 19.1% (31.6% in COPD, 9.8% in non-COPD). To identify the overall role of SRI, we first evaluated the total study population. SRI-SS and its subdomains (except attendance symptoms and sleep), as well as body mass index (BMI), leukocyte number and spirometric indices were associated with long-term survival (p < 0.01 each). Of these, SRI-SS, leukocytes and forced expiratory volume in 1 s (FEV1) turned out to be independent predictors (p < 0.05 each). More specifically, in non-COPD patients SRI-SS and most of its subdomains, as well as leukocyte number, were related to survival (p < 0.05), whereas in patients with COPD only BMI and lung function but not SRI were predictive.<br />Conclusion: In patients with CHRF and HMV, the disease-specific SRI was an overall predictor of long-term survival in addition to established risk factors. However, the SRI predominantly beared information regarding long-term survival in non-COPD patients, while in COPD patients objective measures of the disease state were superior. This on one hand highlights the significance of HRQL in the long-term course of patients with CHRF, on the other hand it suggests that the predictive value of HRQL depends on the underlying disease.
- Subjects :
- Aged
Chronic Disease
Female
Follow-Up Studies
Humans
Hypercapnia epidemiology
Longitudinal Studies
Male
Middle Aged
Prognosis
Prospective Studies
Respiratory Insufficiency epidemiology
Surveys and Questionnaires
Survival Analysis
Cohort Studies
Health Status
Hypercapnia diagnosis
Quality of Life
Respiratory Insufficiency diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1465-993X
- Volume :
- 8
- Database :
- MEDLINE
- Journal :
- Respiratory research
- Publication Type :
- Academic Journal
- Accession number :
- 18086309
- Full Text :
- https://doi.org/10.1186/1465-9921-8-92