Health-Related Quality of Life Varies in Different Respiratory Disorders

A Multi-case Control Population Based Study

Veronica Cappa; Alessandro Marcon; Gianfranco Di Gennaro; Liliya Chamitava; Lucia Cazzoletti; Cristina Bombieri; Morena Nicolis; Luigi Perbellini; Silvia Sembeni; Roberto de Marco; Francesco Spelta; Marcello Ferrari; Maria Elisabetta Zanolin

Disclosures

BMC Pulm Med. 2019;19(32) 

In This Article

Results

Sample Characteristics

Out of 1046 subjects who went to the Verona clinic for tests, 1012 (96.7%) correctly filled-in SF-36 questionnaire and 34 (3.3%) did not (6 did not fill it in completely, 28 did not answer more than three questions). When compared to subjects with an available quality of life questionnaire, subjects without SF-36 were similar to the others, except for a lower education level (41.4% vs 20.4%, p = 0.004), and age (47.1 vs. 44.0, p = 0.047) (Table 1).

Out of 1012 subjects who filled-in the SF-36 questionnaire correctly, 328 (32.4%) were controls, 95 (9.4%) and 163 (16.1%) were NAR and AR respectively, 48 (4.7%) suffered from CB, 126 (12.4%) and 224 (22.1%) were PA and CA cases respectively, and 28 (2.8%) were COPD cases (comorbidities among respiratory diseases are reported in Additional file 2: Figures S1–S4).

Figure S1.

Comorbidities* between respiratory diseases and COPD cases
* COPD=Chronic obstructive pulmonary disease; CA=current asthma; PA=past asthma; AR=allergic rhinitis; NAR=non-allergic rhinitis; No resp. com.=no respiratory comorbidities.

Figure S2.

Comorbidities* between respiratory diseases and current asthma cases
* COPD=Chronic obstructive pulmonary disease; CA=current asthma; AR=allergic rhinitis; NAR=non-allergic rhinitis; No resp. com.=no respiratory comorbidities.
** Cases into dash boxes are considered as COPD cases (n=16), since subjects were hierarchically classified and phenotyped.

Figure S3.

Comorbidities* between respiratory diseases and past asthma cases
* COPD=Chronic obstructive pulmonary disease; PA=past asthma; AR=allergic rhinitis; NAR=non-allergic rhinitis; No resp. com.=no respiratory comorbidities.
** Cases into dash boxes are considered as COPD cases (n=5), since subjects were hierarchically classified and phenotyped.

Figure S4.

Comorbidities* between respiratory diseases and CB cases
* CB=chronic bronchitis; AR=allergic rhinitis; NAR=non-allergic rhinitis; No resp. com.=no respiratory comorbidities.

The characteristics of the 1012 subjects included in the main analyses are described in Table 2. Cases of NAR and PA were prevalently females (61.1 and 57.9% respectively), while cases of COPD were prevalently males (75%; p = 0.021). With respect to the other cases and controls, subjects suffering from COPD were older (52.2 years), had a lower educational status (35.7%) and presented more often other non-respiratory comorbidities (50%). Controls, AR and past asthmatics were mainly never smokers (52.8, 58.9 and 53.2% respectively), while CB and COPD cases had the highest percentage of current smokers (37.5 and 32.1%). Cardiac comorbidities were reported in higher percentages in NAR (25.2%) and CB (22.9%) subjects than other cases and controls. Non-respiratory comorbidities were more frequent in COPD and CB subjects (50.0 and 41.7% respectively).

PCS and MCS Scores

The crude median PCS score of controls (55.1, IQD: 51.8–57.7) was higher than those of subjects suffering from respiratory diseases (p < 0.001). In particular, the physical score of NAR, AR and PA cases was respectively 54.4, 53.9 and 54.2, while the scores of CA, CB and COPD cases were the lowest of the sample (53.6, IQD: 48.8–56.3; 51.0, IQD: 47.4–55–8; 48.9, IQD: 45.9–56.8 respectively) (Figure 2).

Figure 2.

Physical and Mental SF-36 median scores and inter-quartile range by respiratory diseases

Controls and cases of PA had the highest crude median MCS score (52.3, IQD: 47.6–56.1; 52.4, IQD: 46.9–55.9 respectively) followed by NAR, AR and CA (NAR 50.4, IQD: 45.2–56.4; AR 50.7, IQD: 45.1–55.0; CA 50.3, IQD: 41.9–54.9) (Figure 2). Subjects who suffered from CB and COPD had the lowest MCS (CB 47.1, IQD: 41.7–53.8; COPD 46.8, IQD 38.6–56.3 respectively). Median MCS differed among controls and cases (p < 0.001).

The above-mentioned findings were confirmed when the outcomes (PCS and MCS) were adjusted for possible determinants and confounders (Table 3). In general, all the subjects suffering from respiratory diseases showed lower PCS scores than the controls. In particular, in subjects who suffered from CB the median score was 3.8, in current asthmatics 1.7 and COPD cases 5.6 statistically significantly lower than in controls (Table 3). Both AR and NAR did not show a significant difference in HRQL with respect to controls.

The mental score was worse in CB (− 5.5, 95% Confidence Interval-95%CI: − 8.7; − 2.2), current asthmatics (− 2.2, 95%CI: -4.1; − 0.3) and COPD cases (− 4.6, 95%CI: -8.8; − 0.5) (Table 3), like in the case of PCS. Moreover, the AR and NAR mental score did not differ from the controls, similarly to the PCS.

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