Source: Annual Congress 2002 - Prevalence and costs of COPD
Disease area: Airway diseases

Abstract

This study investigated the relationship between Quality of Life (QoL) measures and the GOLD Stage Classification in a population at risk for chronic airflow limitation. Methods: Smokers and ex-smokers of >=10 PPY and age >=50 years underwent medical history, physical examination, chest x-ray, spirometry and completed two questionnaires: the SGRQ and the SF36. Results: 221 subjects (mean age 60 ±] 7 years, mean pack years 43 ±] 23) had complete QoL data (out of 244 entered). The GOLD Classification yielded 83 Normal, 59 Stage 0, 35 Stage I, 36 Stage IIA and 8 Stage IIB. The SGRQ total score and physical component score (PCS) of SF36 identified all Stages of GOLD Classification (P<0.05) compared to Normal with the exception of Stage I (P=0.0756). In addition, for the SGRQ and its component measures (symptoms, activity and impacts on daily life) as well as the PCS of the SF36, there was a monotonic worsening of QoL scores with increasing GOLD stage, with the exception of Stage I. When the GOLD Stage I patients (N = 35) were further stratified into pre-bronchodilator FEF_25-75 of less than 50% predicted (Stage IB, N = 18), both the SGRQ (total score P = 0.0065, symptoms P < 0.00005, and impacts on daily life P = 0.0167) and the PCS of the SF36 (P = 0.0171) identified this newly defined Stage IB as having a statistically significant reduced QoL than the Normal group. Conclusion: In GOLD Stage I COPD, only subjects with a significant reduction in FEF_25-75 had impaired QoL measures. According to these data, to identify clinically important Stage I disease, the GOLD Stage I classification may be further stratified into Stage IA and Stage IB, based on a pre-bronchodilator FEF_25-75 predicted value of >= 50% or < 50% respectively.

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M. R. Maleki-Yazdi, C. K. Lewczuk, F. Kazim, J. M. Haddon, N. B. Choudry (Burlington, Canada). Use of quality of life measures and FEF_25-75 to stratify GOLD stage I COPD into stage IA and stage IB. Eur Respir J 2002; 20: Suppl. 38, 818

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