Longitudinal validity and prognostic significance of the St George's Respiratory Questionnaire in Mycobacterium avium complex pulmonary disease - 18/08/21
Abstract |
Background |
Although previous cross-sectional studies showed the feasibility and clinical association of the St. George's Respiratory Questionnaire (SGRQ) in Mycobacterium avium complex pulmonary disease (MAC-PD), its longitudinal validity is poorly understood. We aimed to determine the longitudinal validity and prognostic significance of SGRQ.
Methods |
In this prospective observational study conducted between May 2012 and August 2018, we evaluated 269 enrolled patients with MAC-PD and examined associations between baseline SGRQ total scores and mortality or clinical variables (anchors), including serum C-reactive protein levels and pulmonary function test results.
Results |
Age- and sex-matched SGRQ scores indicated significantly greater impairment in patients with MAC-PD than in the general population (P < 0.001). On multivariable Cox proportional hazards regression analysis, the SGRQ total score ≥25 was an independent risk factor for mortality (adjusted hazard ratio, 5.90; 95% confidence interval, 1.65–37.7) as well as age, body mass index, and forced vital capacity (FVC). Mixed-effect model results showed a significant association between SGRQ symptom/total scores and forced expiratory volume in 1 s (FEV1), FVC, and diffusing carbon monoxide capacity. Older age, a positive smear, non-nodular/bronchiectatic form, and cavity regions were associated with SGRQ total score deterioration. Patients with a greater decline from baseline FEV1 (% predicted) exhibited significantly worse impairment in the SGRQ total score (mean ± SE, 4.69 ± 10.9 points, P = 0.001).
Conclusions |
SGRQ showed longitudinal validity in assessing disease severity and was sensitive to changes in patients with MAC-PD, especially changes in %FEV1. The SGRQ total score may be an important prognostic factor.
Le texte complet de cet article est disponible en PDF.Highlights |
• | We investigated the longitudinal validity of SGRQ scores in patients with MAC-PD. |
• | Changes in PFTs were significantly associated with those in SGRQ scores. |
• | Older age, smear+, non-NB form, and cavity predicted the decline of SGRQ scores. |
• | The SGRQ total score ≥25 was an independent risk factor for mortality. |
Keywords : Nontuberculous mycobacteria (NTM), Mycobacterium avium/ Mycobacterium intracellulare, Health-related quality of life (HRQL), Prognosis, Pulmonary function tests (PFTs)
Abbreviations : Δ, ABPA, aHR, ANCOVA, ATS/IDSA, BMI, CDF, CI, COPD, CRP, CT, CTD-ILD, DLCO, FEV1, FC, FVC, HR, HRQL, IPF, LAM, MDCT, NB, MAC, MAC-PD, NTM, NTM-PD, PFTs, ROC, SGRQ
Plan
Vol 185
Article 106515- août 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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