scholarly journals The minimal important difference for the St George's Respiratory Questionnaire in patients with severe COPD

2015 ◽  
Vol 46 (6) ◽  
pp. 1598-1604 ◽  
Author(s):  
Jorrit B.A. Welling ◽  
Jorine E. Hartman ◽  
Nick H.T. Ten Hacken ◽  
Karin Klooster ◽  
Dirk-Jan Slebos
Keyword(s):  
Clinical Trials ◽  
Minimal Important Difference ◽  
Forced Expiratory Volume ◽  
Sample Size Determination ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
St George's Respiratory Questionnaire ◽  
Severe Copd

The St George's Respiratory Questionnaire (SGRQ) is a validated, commonly used questionnaire for measuring quality of life in patients with chronic obstructive pulmonary disease (COPD). The current established minimal important difference (MID) for SGRQ scores in an average COPD population is −4 units. However, for patients with severe COPD, the MID has not been thoroughly validated. We re-determined the SGRQ MID for this patient group.115 severe COPD patients (forced expiratory volume in 1 s (FEV1) 26±9% of predicted, SGRQ score 62±11 units; mean±sd,) who participated in seven different bronchoscopic lung volume reduction clinical trials were included in the analysis. Anchor- and distribution-based methods were used to define the MID for SGRQ scores. FEV1, 6-min walk distance and residual volume were used as anchors.Combining both anchor- and distribution-based methods, we identified a SGRQ MID of −8.3 units at 1 month and −7.1 units at 6 months.This study proposes an alternative SGRQ MID for patients with severe COPD of −8.3 units at 1 month and −7.1 units at 6 months follow-up after intervention. Our new MID estimates could be applied for both interpreting SGRQ outcomes as well as sample size determination in future clinical trials investigating interventions in severe COPD patients.

scholarly journals Identification of MMP-9 as a biomarker for detecting progression of chronic obstructive pulmonary disease

2015 ◽  
Vol 93 (6) ◽  
pp. 541-547 ◽  
Author(s):  
Marwa F. Abd El-Fatah ◽  
Mohamed A. Ghazy ◽  
Mohamed S. Mostafa ◽  
May M. El-Attar ◽  
Ahmed Osman
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Fold Increase ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Mrna Levels ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Metalloproteinase 9 ◽  
Severe Copd

Chronic obstructive pulmonary disease (COPD) is a complex immunological disease with multiple pathological features that is primarily induced by smoking together with additional genetic risk factors. COPD is frequently underdiagnosed; forced expiratory volume in the first second (FEV1) is considered to be the main diagnostic measure for COPD, yet it is insufficiently sensitive to monitor disease progression. Biomarkers capable of monitoring COPD progression and severity are needed. In this report, we evaluated matrix metalloproteinase-9 (MMP-9) as an early marker for the detection and staging of COPD, by assessing the mRNA levels of MMP-9 in peripheral blood samples collected from 22 COPD patients, 6 asymptomatic smokers, and 5 healthy controls. Our results demonstrate that the mRNA levels of MMP-9 increased more than two-fold in severe COPD relative to non-COPD smokers or moderate COPD groups. Moreover, in the very severe COPD group, MMP-9 mRNA levels showed a 4-fold increase relative to the non-COPD smokers or the moderate COPD groups, while there was a mild increase (∼40%) when compared to the severe COPD group. Taken together, our results suggest that MMP-9 serves as a biomarker for the grade and severity of COPD.

scholarly journals Erectile dysfunction and sex hormone changes in chronic obstructive pulmonary disease patients

2013 ◽  
Vol 8 ◽  
Author(s):  
Hasan Kahraman ◽  
Bilal Sen ◽  
Nurhan Koksal ◽  
Metin Kilinç ◽  
Sefa Resim
Keyword(s):  
Erectile Dysfunction ◽  
Sexual Dysfunction ◽  
Treatment Plan ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Factors Affecting ◽  
Copd Patients ◽  
Group A

Background: The prevalence of sexual dysfunction in patients with COPD is high and its significance has not been sufficiently stressed. The aim of this study is to investigate the incidence of erectile dysfunction (ED) and the factors affecting its frequency in COPD patients. Methods: Seventy patients with COPD and 68 healthy volunteers were included in the study. The International Index of Erectile Function questionnaire was used to evaluate ED, and the Beck Depression Inventory was used to evaluate depression. Results: The smoking rate was higher and oxygen saturation (SaO2) and body mass index (BMI) were lower in the COPD group. Blood tests revealed higher levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), and estradiol. Testosterone level was lower but it was not statistically significant. Various degrees of ED were detected in 78.6% of COPD patients and 55.8% of the controls. Depression was more common in the COPD group. There was a negative correlation between forced expiratory volume in 1 sec (FEV1) level and ED and between SaO2 and ED in the COPD group. A positive correlation was noted between age and ED in both groups. No significant correlation was found among hormonal status and FEV1, ED, depression, SaO2, or BMI. Conclusions: The present study provides further confirmation that COPD is a risk factor for erectile dysfunction. When establishing a treatment plan for improving the pulmonary function of COPD patients, sexual dysfunction and depression, which are usually neglected but diminish quality of life, should also be addressed.

scholarly journals Impact of cataract on health-related quality of life in a longitudinal Japanese chronic obstructive pulmonary cohort

2017 ◽  
Vol 15 (4) ◽  
pp. 329-338 ◽  
Author(s):  
Hidehiro Irie ◽  
Shotaro Chubachi ◽  
Minako Sato ◽  
Mamoru Sasaki ◽  
Naofumi Kameyama ◽  
...  
Keyword(s):  
Quality Of Life ◽  
At Risk ◽  
Chronic Obstructive ◽  
Health Related Quality ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Related Quality ◽  
Health Related ◽  
St George's Respiratory Questionnaire

Cigarette smoking increases the risk of developing both cataract and chronic obstructive pulmonary disease (COPD). The prevalence of cataract and the clinical characteristics of COPD patients with cataract were retrospectively investigated in a 2-year observational COPD cohort. We analyzed 395 patients with complete data on ophthalmologic evaluation (319 subjects with COPD and 76 subjects at risk of COPD). There was no difference in the prevalence of cataract between COPD patients and those at risk (47.0% vs. 42.1%, p = 0.44). Age ≥ 75 years, low body mass index, and hypertension were independently associated with cataract as a comorbidity in COPD. The incidence of exacerbation within 2 years was significantly higher in COPD patients with cataract than those without cataract (36.6% vs. 18.3%, p = 0.0019). COPD patients with cataract exhibited significantly higher COPD assessment test score compared to those without cataract (13.7 ± 8.9 vs. 11.5 ± 7.2, p = 0.0240). Overall St George’s Respiratory Questionnaire score and each component were significantly worse in COPD patients with cataract compared to those without cataract. COPD patients with cataract exhibited poor health-related quality of life and frequent exacerbations. The association between cataract and exacerbations of COPD deserves further attention.

scholarly journals Real‑life cost and cost‑effectiveness for tiotropium 18 μg od monotherapy in moderate and severe COPD patients: a 48‑month survey

2014 ◽  
Vol 15 (2) ◽  
pp. 39-44
Author(s):  
Massimiliano Povero ◽  
Lorenzo Pradelli ◽  
Paola Turco ◽  
Roberto Walter Dal Negro
Keyword(s):  
Cost Effectiveness ◽  
Maintenance Therapy ◽  
Real Life ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Positive Effects ◽  
Copd Patients ◽  
Therapy Cost ◽  
Severe Copd

BACKGROUND: Tiotropium monotherapy enables a significant minimization of morbidity in COPD. OBJECTIVE: to evaluate and compare cost and cost‑effectiveness of tiotropium monotherapy administrated for 24 months (18 μg od) in mild‑to‑moderate and severe chronic obstructive pulmonary disease (COPD). METHODS: Clinical outcomes (days in hospital; visits in general ward; cycles of systemic steroids; cycles of antibiotics and maintenance therapy drugs) were evaluated in two groups of patients corresponding to predicted FEV1 baseline values ≤ 50% (A) and > 50% (B) from the Italian NHS perspective. In order to perform cost‑effectiveness analysis, FEV1 value, available for each patient, was converted in SGRQ score using a published multivariate linear model. Utilities were then obtained through the Ståhl equation. RESULTS: The comparison between 24 months of standard therapy and subsequent 24‑month period of tiotropium monotherapy showed that hospitalization cost, which represents the driving treatment cost, drops from 77% to 69% (A) and from 67% to 33% (B) of the total cost. Differently, maintenance therapy cost increased but the amount was more than offset by the savings accruing from the shortening of hospitalization. Furthermore, cost‑effectiveness results revealed a mean savings of about 216 € (A) and 961 € (B) other than a mean gain of 0.07 QALY (A) and 0.02 QALY (B). Dominance of tiotropium (calculated only within patients completing treatment course) revealed that in almost 29% (A) and 36% (B) of subjects tiotropium strategy is dominant while only in 2% (A) and 7% (B) of cases is associated to costs increment and worsening on quality of life. The dominance was systematic in severe COPD. Statistical analyses confirm such trend. CONCLUSIONS: Results of the present study suggest that tiotropium used as unique treatment in COPD systematically consents significant costs savings together with positive effects on evaluated quality. These effects prove proportional to COPD severity. 

scholarly journals Questionnaires

2004 ◽  
Vol 11 (7) ◽  
pp. 469-470
Author(s):  
Nick R Anthonisen
Keyword(s):  
Quality Of Life ◽  
Chronic Obstructive ◽  
Life Questionnaire ◽  
Obstructive Pulmonary Disease ◽  
Chronic Respiratory Questionnaire ◽  
Copd Patients ◽  
Standard Quality ◽  
St George's Respiratory Questionnaire ◽  
Met Expectations

In this issue of theCanadian Respiratory Journal, Bourbeau et al (pages 480-486) publish what could be loosely described as a validation of a French-Canadian translation of the Chronic Respiratory Questionnaire (CRQ) (1) and the St George's Respiratory Questionnaire (SGRQ) (2). They translated the questionnaires and went over them in detail until they were convinced that the questionnaires actually asked the questions that they were supposed to. They then administered them to two groups of chronic obstructive pulmonary disease (COPD) patients. One group had stable COPD and was tested twice with a two-week period between tests to examine test-retest reproducibility. The second group consisted of patients who either had an exacerbation of their COPD or who underwent rehabilitation for their disease. Both situations are associated with improvements in quality of life that should be detectable by the questionnaires. These results were compared with a third standard quality of life questionnaire. The results were very good. The questionnaire results met expectations: they were reproducible in stable patients and showed when patients improved. In psychometric terms, they were reliable and valid. I recommend the paper to people who are interested in developing and testing such instruments, both for the knowledge displayed by the authors and for the clarity of their presentation.

scholarly journals Lung Body Plethysmography: From Functional to Clinical Aspects for Prediction of Quality of Life in Patients with Chronic Pulmonary Obstruction

2019 ◽  
Vol 70 (11) ◽  
pp. 3935-3941
Author(s):  
Roxana Maria Nemes ◽  
Florentina Ligia Furtunescu ◽  
Ioan Sorin Tudorache ◽  
Tudor Harsovescu ◽  
Alexandra Floriana Nemes ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Forced Expiratory Volume ◽  
Normal Weight ◽  
Clinical Aspects ◽  
Chronic Obstructive ◽  
Body Plethysmography ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Number Of Patients

We analyze the lung function using advanced measurement (body plethysmography) and standard measurement (spirometry) in stable COPD (Chronic Obstructive Pulmonary Disease) patients. Subjects and methods: 211 patients with stable COPD (88.6% males) age 61�5 years (mean � standard deviation), exsmokers 78.7%, underwent to: body pletysmography , spirometry, electrocardiography. Parameters obtained: residual volume (RV), forced expiratory volume in 1 second (FEV1), were correlated with different parameters and also for prediction of quality of life in COPD patients. In assessing the quality of life we used the St. George�s Respiratory Questionnaire (SGRQ). According to BMI (body mass index) we classify patients in four groups: 1. underweight ([ 20, n = 34), 2. normal weight (20-24, n = 79), 3. overweight (25-29.9, n = 58), 4. obese ( ]30, n = 40), n = number of patients.

scholarly journals Lung Body Plethysmography: From Functional to Clinical Aspects for Prediction of Quality of Life in Patients with Chronic Pulmonary Obstruction

2019 ◽  
Vol 70 (11) ◽  
pp. 3935-3941
Author(s):  
Roxana Maria Nemes ◽  
Florentina Ligia Furtunescu ◽  
Ioan Sorin Tudorache ◽  
Tudor Harsovescu ◽  
Alexandra Floriana Nemes ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Forced Expiratory Volume ◽  
Normal Weight ◽  
Clinical Aspects ◽  
Chronic Obstructive ◽  
Body Plethysmography ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Number Of Patients

We analyze the lung function using advanced measurement (body plethysmography) and standard measurement (spirometry) in stable COPD (Chronic Obstructive Pulmonary Disease) patients. Subjects and methods: 211 patients with stable COPD (88.6% males) age 61�5 years (mean � standard deviation), exsmokers 78.7%, underwent to: body pletysmography , spirometry, electrocardiography. Parameters obtained: residual volume (RV), forced expiratory volume in 1 second (FEV1), were correlated with different parameters and also for prediction of quality of life in COPD patients. In assessing the quality of life we used the St. George�s Respiratory Questionnaire (SGRQ). According to BMI (body mass index) we classify patients in four groups: 1. underweight ([ 20, n = 34), 2. normal weight (20-24, n = 79), 3. overweight (25-29.9, n = 58), 4. obese ( ]30, n = 40), n = number of patients.

scholarly journals Validation of Clinical Characteristics and Effectiveness of Pulmonary Rehabilitation in a COPD Population with Discrepancy between Exercise Tolerance and FEV1

Healthcare ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 53
Author(s):  
Jun Horie ◽  
Koichiro Takahashi ◽  
Shuuichi Shiranita ◽  
Kunihiko Anami ◽  
Shinichiro Hayashi
Keyword(s):  
Gait Speed ◽  
Pulmonary Rehabilitation ◽  
Exercise Tolerance ◽  
Respiratory Illness ◽  
Forced Expiratory Volume ◽  
Walking Distance ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
St George's Respiratory Questionnaire ◽  
History Of

This study’s objective was to examine the characteristics of patients with chronic obstructive pulmonary disease (COPD) presenting with various exercise tolerance levels. A total of 235 patients with stable COPD were classified into 4 groups: (1) LoFlo + HiEx—patients with a six-minute walking distance (6MWD) ≥350 m and percentage of predicted forced expiratory volume in 1 s (%FEV1.0) <50%; (2) HiFlo + HiEx—patients with a 6MWD ≥350 m and a %FEV1.0 ≥50%; (3) LoFlo + LoEx—patients with a 6MWD < 350 m and %FEV1.0 < 50%; and (4) HiFlo + LoEx—patients with a 6MWD <350 m and %FEV1.0 ≥ 50%. Aspects of physical ability in the HiFlo + LoEx group were significantly lower than those in the HiFlo + HiEx group. The HiFlo + LoEx group was characterized by a history of hospitalization for respiratory illness within the past year, treatment with at-home oxygen therapy, and lacking daily exercise habits. Following three months of pulmonary rehabilitation, the LoFlo + HiEx group significantly improved in the modified Medical Research Council dyspnea score, maximum gait speed, and 6MWD, while the HiFlo + LoEx group significantly improved in the percentage of maximal expiratory pressure, maximum gait speed, 6MWD, incremental shuttle walking distance, and St. George’s Respiratory Questionnaire score. The HiFlo + LoEx group had the greatest effect of three-month pulmonary rehabilitation compared to other groups.

scholarly journals Serum Albumin Concentrations in Stable Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (2) ◽  
pp. 269
Author(s):  
Elisabetta Zinellu ◽  
Alessandro G. Fois ◽  
Elisabetta Sotgiu ◽  
Sabrina Mellino ◽  
Arduino A. Mangoni ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Obstructive Pulmonary Disease ◽  
Serum Albumin ◽  
Pulmonary Disease ◽  
Meta Analysis ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Standard Mean Difference ◽  
Copd Patients

Background: Chronic obstructive pulmonary disease (COPD) is a progressive condition characterized by chronic airway inflammation and lung parenchyma damage. Systemic inflammation and oxidative stress also play a role in the pathogenesis of COPD. Serum albumin is a negative acute-phase protein with antioxidant effects and an important marker of malnutrition. The aim of this meta-analysis was to investigate differences in serum albumin concentrations between patients with stable COPD and non-COPD subjects. Methods: A systematic search was conducted, using the terms “albumin” and “chronic obstructive pulmonary disease” or “COPD”, in the electronic databases PubMed and Web of Science, from inception to May 2020. Results: Twenty-six studies were identified on a total of 2554 COPD patients and 2055 non-COPD controls. Pooled results showed that serum albumin concentrations were significantly lower in COPD patients (standard mean difference, SMD = −0.50, 95% CI −0.67 to −0.32; p < 0.001). No significant differences were observed in SMD of serum albumin concentrations between COPD patients with forced expiratory volume in the 1st second (FEV1) < 50% and those with FEV1 > 50%. Conclusions: Our systematic review and meta-analysis showed that serum albumin concentrations are significantly lower in patients with stable COPD compared to non-COPD controls. This supports the presence of a deficit in systemic anti-inflammatory and antioxidant defense mechanisms in COPD.

scholarly journals Single-inhaler fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) triple therapy versus tiotropium monotherapy in patients with COPD

2021 ◽  
Vol 31 (1) ◽  
Author(s):  
Sandeep Bansal ◽  
Martin Anderson ◽  
Antonio Anzueto ◽  
Nicola Brown ◽  
Chris Compton ◽  
...  
Keyword(s):  
Health Status ◽  
Triple Therapy ◽  
Treatment Guidelines ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Fluticasone Furoate ◽  
Double Blind ◽  
Once Daily ◽  
Copd Patients ◽  
Severe Copd

AbstractChronic obstructive pulmonary disease (COPD) treatment guidelines do not currently include recommendations for escalation directly from monotherapy to triple therapy. This 12-week, double-blind, double-dummy study randomized 800 symptomatic moderate-to-very-severe COPD patients receiving tiotropium (TIO) for ≥3 months to once-daily fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) 100/62.5/25 mcg via ELLIPTA (n = 400) or TIO 18 mcg via HandiHaler (n = 400) plus matched placebo. Study endpoints included change from baseline in trough forced expiratory volume in 1 s (FEV1) at Days 85 (primary), 28 and 84 (secondary), health status (St George’s Respiratory Questionnaire [SGRQ] and COPD Assessment Test [CAT]) and safety. FF/UMEC/VI significantly improved trough FEV1 at all timepoints (Day 85 treatment difference [95% CI] 95 mL [62–128]; P < 0.001), and significantly improved SGRQ and CAT versus TIO. Treatment safety profiles were similar. Once-daily single-inhaler FF/UMEC/VI significantly improved lung function and health status versus once-daily TIO in symptomatic moderate-to-very-severe COPD patients, with a similar safety profile.

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