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Chest Infections |

Health-Related Quality of Life and Impairment of Lung Function in Elderly 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):216A. doi:10.1378/chest.1385732
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Abstract

SESSION TYPE: Respiratory Infections Posters I

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

PURPOSE: In 2008 the tuberculosis (TB) incidence rates of the elderly population aged 65 or older was 35,8 per 100,000 in Russia. The aim of the study was to evaluate prevalence of pulmonary function abnormalities and to assess quality of life (QoL) in elderly patients who had been treated for pulmonary tuberculosis.

METHODS: We investigated 61 patients aged 65 or older and for comparison 248 younger persons with tuberculosis sequelae. Spirometry was performed at least one year after treatment. The St. George Respiratory Questionnaire (SGRQ) and UCSD Shortness of Breath Questionnaire (SOBQ) were used for assessment of QoL.

RESULTS: In elderly patients pulmonary impairment was present in 40 (65,6%) patients including 31 (50,8%) patients with airway obstruction (FEV1/FVC <0.7) and 9 (14,8%) patients with restrictive pattern (FEV1 or FVC<80% predicted and FEV1/FVC ≥0.7) Out of 61 patients, 31 (50,8%) had low pulmonary function (FEV1 < 80% predicted). According to ATS/ERS criteria we classified 13,1% of subjects as having mild impairment; 16,4% of subjects as having moderate impairment; and 21,3% of subjects as having severe impairment. Out of 248 younger patients, 121 (48,8%) had pulmonary impairment (p<0.05) and 85 (34,3%) had low pulmonary function (p<0.05). In patients older 65 years and younger persons, respectively, SGRQ Symptoms scores were 35,3±25,5% and 25,0±23,9% (difference was 10.2 points, p<0.05); SGRQ Activity scores were 46,0±24,0% and 24,4±21,0% (difference was 21.6 points, p<0.001); SGRQ Impact scores were 28,0±22,1% and 14,1±17,7% (difference was 13.9 points, p<0.001); SGRQ Total scores were 34,5±21,4% and 18,9±18,4% (difference was 15.6 points, p<0.001); SOBQ scores were 30,3±23,9% and 11,6±13,9% (difference was 18.7 points, p<0.001). In elderly patients with impaired spirometry results (FEV1<80%) and normal spirometry results SGRQ Total scores were 39,8±20,0% and 29,1±21,6% (difference was 10.7 points, p <0,05).

CONCLUSIONS: A microbiological cure is not the end of illness. In elderly patients tuberculosis is associated with frequent pulmonary impairment. Quality of life in elderly patients treated for pulmonary tuberculosis was worse than in younger persons. The main factor influencing quality of life was impaired pulmonary function.

CLINICAL IMPLICATIONS: This supports the importance of pulmonary function testing in elderly patients during the course of treatment and after a cure.

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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