Relationship between lung function impairment and health-related quality of life in COPD and ILD.
Health-related quality of life (HRQL) measures have been correlated with lung function in patients with chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD). However, different pathophysiologic mechanisms may influence how these distinct diseases affect HRQL, resulting in differing HRQL by pulmonary diagnosis among patients with similar severity of ventilatory impairment.
Methods : The NHLBI Lung Tissue Research Consortium provided data on well-characterized participants with COPD (n=576) and ILD (n=405) at four clinical sites. Using multiple linear regression, we examined the effects of FEV(1) (% predicted) and diagnosis (ILD versus COPD) on HRQL scores, including total St. George's Respiratory Questionnaire (SGRQ) scores and Short Form-12 physical component summary (PCS) and mental component summary (MCS) scores.
Results : Participants with ILD had on average higher SGRQ scores (15.33 points; 95% CI 12.46, 18.19; p<0.001) and lower SF-12 PCS scores (-4.73 points; 95% CI -6.31,-3.14; p<0.001) compared to COPD patients with similar FEV(1) % predicted values, indicating worse HRQL. The specific diagnosis also modified the effect of FEV(1) on the total SGRQ score (p=0.003) and the SF-12 PCS score (p=0.03). There was no relationship between lung function and SF-12 MCS scores.
Conclusion : HRQL scores were worse for ILD patients compared to COPD patients with similar degrees of ventilatory impairment. Differences in dyspnea mechanism or in the rate of disease progression may account for these differences in HRQL.