Brandl Magdalena, Böhmer Merle M, Brandstetter Susanne, Finger Tamara, Fischer Wiebke, Pfeifer Michael, Apfelbacher Christian
Medical Sociology, Department for Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany.
Bavarian Health and Food Safety Authority, Munich, Germany.
J Thorac Dis. 2018 Feb;10(2):766-775. doi: 10.21037/jtd.2018.01.122.
Health-related quality of life (HRQOL) is impaired in chronic obstructive pulmonary disease (COPD) patients, but determining factors for HRQOL are still not unequivocal. This study measures HRQOL among patients with COPD and aims to determine factors associated with HRQOL.
Data for cross-sectional analyses were obtained from the baseline of a cohort study. The study population includes adult COPD patients (disease duration ≥3 months), recruited from primary and secondary care settings in Germany, without acute psychiatric/neurologic disease (exception: affective/ anxiety disorders). HRQOL was assessed using the Short-Form 12 (SF-12) Health Survey Questionnaire, comprising a physical and mental component. Independent variables encompass socio-demographic, disease-specific, treatment-related and psychological factors. Multivariable linear regression analyses were conducted.
In total, 206 COPD patients (60.7% male; mean age: 65.3 years) took part in the study. In multivariable analysis, the physical component score showed a significant negative association with the COPD Assessment Test (CAT) (P<0.001) and a higher total number of prescribed medications (P=0.001). A higher forced expiratory volume in 1 second (FEV1) value in percent predicted was significantly related to the physical component score in a positive manner (P=0.006). The mental component score was significantly associated with elevated patient-reported symptoms of anxiety (P=0.002) or depression (P<0.001), measured by the hospital anxiety and depression scale (HADS) in a negative way. Like for the physical component score (P<0.001), a worse CAT score was significantly associated with a lower mental component score (P=0.033).
Focusing on patient reported outcomes and screening for depression and anxiety with potential successive treatment might be promising approaches to improve HRQOL in patients with COPD.
慢性阻塞性肺疾病（COPD）患者的健康相关生活质量（HRQOL）受损，但HRQOL的决定因素仍不明确。本研究测量了COPD患者的HRQOL，并旨在确定与HRQOL相关的因素。
横断面分析的数据取自一项队列研究的基线。研究人群包括成年COPD患者（病程≥3个月），从德国的初级和二级医疗机构招募，无急性精神/神经疾病（例外情况：情感/焦虑障碍）。使用简短健康调查问卷12项版（SF-12）评估HRQOL，该问卷包括身体和心理两个部分。自变量包括社会人口统计学、疾病特异性、治疗相关和心理因素。进行了多变量线性回归分析。
共有206例COPD患者（男性占60.7%；平均年龄：65.3岁）参与了研究。在多变量分析中，身体部分得分与COPD评估测试（CAT）呈显著负相关（P<0.001），与开具的药物总数较多呈显著负相关（P=0.001）。以预测值百分比表示的较高的1秒用力呼气量（FEV1）值与身体部分得分呈显著正相关（P=0.006）。心理部分得分与患者报告的焦虑症状（P=0.002）或抑郁症状（P<0.001）升高显著相关，通过医院焦虑抑郁量表（HADS）测量呈负相关。与身体部分得分情况一样（P<0.001），较差的CAT得分与较低的心理部分得分显著相关（P=0.033）。
关注患者报告的结果并筛查抑郁和焦虑，并进行可能的后续治疗，可能是改善COPD患者HRQOL的有前景的方法。
