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Original Research |

Relationship Between Lung Function Impairment and Health-Related Quality of Life in COPD and Interstitial Lung DiseaseLife Quality in COPD and Interstitial Lung Disease

Cristine E. Berry, MD; M. Bradley Drummond, MD; MeiLan K. Han, MD; Daner Li, MS; Cathy Fuller, MS; Andrew H. Limper, MD, FCCP; Fernando J. Martinez, MD, FCCP; Marvin I. Schwarz, MD, FCCP; Frank C. Sciurba, MD, FCCP; and; Robert A. Wise, MD, FCCP
Author and Funding Information

From the Division of Pulmonary and Critical Care Medicine (Drs Berry, Drummond, and Wise), Johns Hopkins University School of Medicine, Baltimore, MD; the Division of Pulmonary and Critical Care Medicine (Drs Han and Martinez), University of Michigan Health System, Ann Arbor, MI; the C-TASC Clinical Trials and Surveys Corporation (Mss Li and Fuller), Owings Mills, MD; the Division of Pulmonary and Critical Care Medicine (Dr Limper), Mayo Clinic College of Medicine, Rochester, MN; the Division of Pulmonary Sciences and Critical Care Medicine (Dr Schwarz), University of Colorado, Denver School of Medicine, Aurora, CO; and the Division of Pulmonary and Critical Care Medicine (Dr Sciurba), University of Pittsburgh School of Medicine, Pittsburgh, PA.

Correspondence to: Robert A. Wise, MD, FCCP, Johns Hopkins Asthma and Allergy Center, 5501 Hopkins Bayview Circle, Baltimore, MD 21224; e-mail: rwise@jhmi.edu


Funding/Support: This study was supported by the National Institutes of Health [Grant 1KL2RR025006-01] and the National Heart, Lung, and Blood Institute [Grant NO1-HR-46164].

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2012;142(3):704-711. doi:10.1378/chest.11-1332
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Background:  Health-related quality-of-life (HRQL) measures have been correlated with lung function in patients with 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 National Heart, Lung, and Blood Institute 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 FEV1 (% predicted) and diagnosis (ILD vs COPD) on HRQL scores, including total St. George Respiratory Questionnaire (SGRQ) scores and Short Form-12 (SF-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 <.001) and lower SF-12 PCS scores (×4.73 points; 95% CI, ×6.31 to ×3.14; P <.001) compared with patients with COPD with similar FEV1 % predicted values, indicating worse HRQL. The specific diagnosis also modified the effect of FEV1 on the total SGRQ score (P = .003) and the SF-12 PCS score (P = .03). There was no relationship between lung function and SF-12 MCS scores.

Conclusions:  HRQL scores were worse for patients with ILD compared with patients with COPD with similar degrees of ventilatory impairment. Differences in dyspnea mechanism or in the rate of disease progression may account for these differences in HRQL.

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