Incalzi R A, Bellia V, Catalano F, Scichilone N, Imperiale C, Maggi S, Rengo F
Istituto di Medicina Interna e Geriatria, Catholic University of Rome, Italy.
Chest. 2001 Sep;120(3):734-42. doi: 10.1378/chest.120.3.734.
To compare the effects of asthma and COPD on health status (HS) in elderly patients, and to assess the correlation between disease-specific and generic instruments assessing HS.
Multicenter, cross-sectional, observational study.
The Salute Respiratoria nell'Anziano (respiratory health in the elderly) Study network of outpatient departments.
One hundred ninety-eight asthma patients and 230 COPD patients > or = 65 years old.
HS was assessed by the Saint George's Respiratory Questionnaire (SGRQ) and five generic outcomes: Barthel's index, 6-min walk test, mini mental state examination, geriatric depression scale (GDS), and quality-of-sleep index. Independent correlates of SGRQ scores were assessed by logistic regression. Patients were considered to have a "good" HS or "poor" HS according to whether they did or did not perform worse than 75% of the corresponding population of asthma or COPD patients, on at least two of the five generic outcomes.
On average, COPD patients had poorer HS than asthma patients on the SGRQ. Only polypharmacy (more than three respiratory drugs) and diagnosis of COPD qualified as independent correlates of the SGRQ score. The SGRQ "Activity" and "Impacts" scores shared the following independent correlates: polypharmacy, Barthel's index < 92, and GDS > 6. Further correlates were waist/hip ratio > 1 for the Activity score, and age and occiput-wall distance > 9 cm for the Impacts score. All sections of the SGRQ except for the Symptoms score could significantly distinguish patients with good HS and poor HS.
Individual dimensions of HS recognize different determinants. COPD outweighs asthma as a cause of distressing respiratory symptoms. A high degree of concordance exists between SGRQ and generic health outcomes, except for the Symptoms dimension in COPD patients.
比较哮喘和慢性阻塞性肺疾病（COPD）对老年患者健康状况（HS）的影响，并评估评估HS的疾病特异性和通用工具之间的相关性。
多中心、横断面、观察性研究。
老年呼吸健康研究门诊网络。
198例年龄≥65岁的哮喘患者和230例COPD患者。
通过圣乔治呼吸问卷（SGRQ）和五个通用指标评估HS：巴氏指数、6分钟步行试验、简易精神状态检查、老年抑郁量表（GDS）和睡眠质量指数。通过逻辑回归评估SGRQ评分的独立相关因素。根据患者在五个通用指标中的至少两项上的表现是否比相应的哮喘或COPD患者群体的75%更差，将患者视为具有“良好”或“较差”的HS。
平均而言，COPD患者在SGRQ上的HS比哮喘患者差。只有联合用药（超过三种呼吸药物）和COPD诊断被认为是SGRQ评分的独立相关因素。SGRQ“活动”和“影响”评分具有以下共同的独立相关因素：联合用药、巴氏指数<92和GDS>6。活动评分的进一步相关因素是腰臀比>1，影响评分的相关因素是年龄和枕墙距离>9cm。除症状评分外，SGRQ的所有部分都能显著区分HS良好和较差的患者。
HS的各个维度识别不同的决定因素。作为令人痛苦的呼吸道症状的原因，COPD比哮喘更严重。SGRQ与通用健康指标之间存在高度一致性，但COPD患者的症状维度除外。
