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Pulmonary Physiology |

Using Quality of Life Questionnaires for Predicting Low Lung Function in Patients With Treated Pulmonary Tuberculosis

Mikhail Chushkin*, MD; Sergey Mandrykin, MD; Eduard Tikhokhod, MD; Sergey Smerdin, MD
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Research Institute of Phthisiopulmonology, Moscow, Russian Federation


Chest. 2012;142(4_MeetingAbstracts):793A. doi:10.1378/chest.1385726
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Abstract

SESSION TYPE: Physiology/PFTs/ Rehabilitation Posters

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: Tuberculosis is associated with frequent pulmonary impairment. This supports performance of pulmonary function tests in the course of treatment and after a cure but until now pulmonary function testing has not been included in tuberculosis treatment guidelines. The aim of the study was to assess the usefulness quality of life (QoL) questionnaire for predicting low lung function in patients after treatment of pulmonary tuberculosis.

METHODS: We investigated 302 patients who were cured for pulmonary tuberculosis (186 males and 116 females). QoL was studied by St. George's Respiratory Questionnaire (SGRQ) and UCSD Shortness of Breath Questionnaire (SOBQ). Pulmonary function was studied by spirometry. Receiver Operating Characteristic (ROC) curve analysis was used for assessment of sensitivity and specificity.

RESULTS: Out of 302 patients, 114 (37,7%) had low lung function (FEV1 < 80% predicted). According to ATS/ERS criteria we classified 8,9% of subjects as having mild impairment; 17,9% of subjects as having moderate impairment; and 10,9% of subjects as having severe impairment. According ROC curve analysis for low lung function, when 25,74% of Total SGRQ score was chosen as the cut-off, sensitivity was 60,5% and specificity was 83,5%. Area under the ROC curve (AUC) was 0,78 (95% confidential interval [CI] 0.73 to 0.84; p<0.001). For Symptoms SGRQ score the cut-off was 31,25%, sensitivity was 57,9% and specificity was 78,7%. AUC was 0,73 (95% CI 0.68 to 0.79; p<0.001). For Activity SGRQ score the cut-off was 29,48%, the sensitivity72,8% and specificity was 69,7%. AUC was 0,77 (95% CI 0.72 to 0.83; p<0.001). For Impact SGRQ score the cut-off was 15,77%, sensitivity was 62,3% and specificity was 80,9%. AUC was 0,77 (95% CI 0.71 to 0.82; p<0.001). For SOBQ score the cut-off was 9 points, sensitivity was 73,2% and specificity was 66,1%. AUC was 0,73 (95% CI 0.67 to 0.79; p<0.001). AUC was a bit bigger in male than in female (0,81 vs. 0,75). In patients older 40 years, when 29,67% of Total SGRQ score was chosen as the cut-off, sensitivity was 61,2% and specificity was 71,8%. Area under the ROC curve (AUC) was 0,76 (95% CI 0.69 to 0.82; p<0.001).

CONCLUSIONS: SGRQ may be useful in detection of pulmonary impairment. Total SGRQ of 25,74% may be the best cut-off. Higher Total SGRQ score was associated with higher probability of low pulmonary function.

CLINICAL IMPLICATIONS: Pulmonary function testing should be recommended in patients with Total SGRQ more 25%.

DISCLOSURE: The following authors have nothing to disclose: Mikhail Chushkin, Sergey Mandrykin, Eduard Tikhokhod, Sergey Smerdin

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Research Institute of Phthisiopulmonology, Moscow, Russian Federation

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