OBJECTIVE: Estimate predictive validity for health status measure, the St. George's Respiratory Questionnaire (SGRQ), among patients with COPD.METHOD: We used SGRQ data from the COPD Biomarker Qualification Consortium database of pooled individual patient data from medium term randomized clinical trials (N=12,043). Adjusted Hazard Ratios (HR) and 95% Confidence Intervals (95%CI) were used to estimate the association between quartiles of SGRQ at baseline, time to first event and time from first to second event for COPD exacerbations, hospital admissions for COPD, and all-cause death.RESULTS: Risk of COPD outcomes increased with increasing quartiles of SGRQ score for all time to first event analyses; p for trend across quartiles <0.0001. Risk estimates for time to second event followed the same pattern; HR failed reaching statistical significance for hospital admissions

Risk of COPD outcomes by baseline SGRQ; HR (95% CI)
SGRQ quartile (score range)ExacerbationRecurrent ExacerbationHospital admissionRecurrent Hospital admissionMortality
1st (0<32)
2nd (32<46)1.19 (1.11-1.28)1.18 (1.08-1.30)1.27 (1.11-1.44)1.10 (0.87-1.40)1.35 (1.11-1.64)
3rd (46<60)1.28 (1.19-1.38)1.20 (1.09-1.32)1.53 (1.35-1.74)1.18 (0.94-1.50)1.71 (1.42-2.07)
4th (=>60)1.40 (1.29-1.51)1.26 (1.14-1.40)2.01 (1.78-2.28)1.46 (1.16-1.83)2.30 (1.91-2.78)
.CONCLUSION: In patients with COPD, SGRQ predicts long term outcomes of exacerbation of COPD, hospital admissions, their recurrence and death. Health status assessment should be a part of risk assessment for COPD patients in routine medical care.