Abstract
Background: IPF is a progressive, fibrosing lung disease causing diminished health related quality of life (HRQoL).
Aims: We sort to determine the principal determinants of HRQoL in IPF.
Methods: Data from the Australian IPF Registry included demographic features, comorbidities, St George Respiratory Questionnaire (SGRQ), Hospital Anxiety & Depression (HAD-A & D) scale, UCSD Shortness of BreathQuestionnaire (UCSD), cough, oxygen use, spirometry, DLCO & 6MWT parameters. Linear regression analysis was performed to identify predictors of HRQoL.
Results: Data from 516 patients was available (347 male; mean (SD) age 71.3±8.6 yrs). Mean FVC 81.3±22.5%pr, DLco 46.7±17.4%pr, 6MWD 434±135m, resting SpO2 95.1±3.3%, end-exercise SpO284.8±6.9%. SGRQ: Symptom 47.2±23.5; Activity 61.9±23.9; Impact 37.3±22.9; Total 46.6±20.9. Symptom scores: UCSD median (IQR) 38 (17-67); HAD-A Score 4 (2-7), 20.3% > 8, HAD-D Score 4 (2-7), 17.7% > 8; cough presence 88.5%; cough severity (visual analogue scale 0-100mm): 40.3±25.8. Significant associations with HRQoL on univariate analysis included: GAP index, smoking, cardiorespiratory comorbidity, oxygen therapy, UCSDSOBQ, HAD-A, HAD-D, cough presence & severity, FEV1, FVC, DLCO, 6MWD, baseline & end test oxygen saturation, & end 6MWT dyspnea score. Multivariate analysis of 109 subjects with complete data demonstrated independent association between SGRQ and UCSDSOBQ (R2 = 0.76, p<0.0001), cough severity (R2 = 0.07, p<0.0001), HAD-D (R2 = 0.02, p=0.003) & age (R2 = 0.01, p=0.015).
Conclusions: Cough, dyspnoea & depression, are major determinants of HRQoL in IPF. Their treatment may improve HRQoL, & should be a focus of future clinical trials.
- Copyright ©ERS 2015