Longitudinal validity and prognostic significance of the St George's Respiratory Questionnaire in Mycobacterium avium complex pulmonary disease. (August 2021)

• Record Type: Journal Article
• Authors: Ogawa, Takunori; Asakura, Takanori; Suzuki, Shoji; Okamori, Satoshi; Kusumoto, Tatsuya; Sato, Yasunori; Namkoong, Ho; Kamata, Hirofumi; Ishii, Makoto; Fukunaga, Koichi; Hasegawa, Naoki
• Is Part Of: Respiratory medicine. Volume 185(2021)
• Publication Date: 2021-08
• Subjects: Nontuberculous mycobacteria (NTM) -- Mycobacterium avium/ Mycobacterium intracellulare -- Health-related quality of life (HRQL) -- Prognosis -- Pulmonary function tests (PFTs); Δ delta -- ABPA allergic bronchopulmonary aspergillosis -- aHR adjusted HR -- ANCOVA analysis of covariance -- ATS/IDSA American Thoracic Society/Infectious Disease Society of America/Infectious Disease Society of America -- BMI body mass index -- CDF cumulative distribution function -- CI confidence interval -- COPD chronic obstructive pulmonary disease -- CRP C-reactive protein -- CT computed tomography -- CTD-ILD connective tissue disease-associated interstitial lung disease -- DLCO diffusing capacity for carbon monoxide -- FEV1 forced expiratory volume in 1 s -- FC fibrocavitary -- FVC forced vital capacity -- HR hazard ratio -- HRQL health-related quality of life -- IPF idiopathic pulmonary fibrosis -- LAM lymphangioleiomyomatosis -- MDCT multidetector-row CT -- NB nodular/bronchiectatic -- MAC Mycobacterium avium complex -- MAC-PD Mycobacterium avium complex pulmonary disease -- NTM nontuberculous mycobacteria -- NTM-PD nontuberculous mycobacterial pulmonary disease -- PFTs pulmonary function tests -- ROC receiver operating characteristic -- SGRQ St George's Respiratory Questionnaire; Chest -- Diseases -- Periodicals; Chest -- Diseases -- Great Britain -- Periodicals; Respiratory organs -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Appareil respiratoire -- Maladies -- Périodiques; Thorax -- Maladies -- Périodiques; Appareil respiratoire -- Maladies -- Traitement -- Périodiques; Electronic journals; 616.2
• DOI: 10.1016/j.rmed.2021.106515
• Languages: English
• ISSNs: 0954-6111

Abstract

Abstract: Background: Although previous cross-sectional studies showed the feasibility and clinical association of the St. George's Respiratory Questionnaire (SGRQ) in Mycobacterium avium complex pulmonary disease (MAC-PD), its longitudinal validity is poorly understood. We aimed to determine the longitudinal validity and prognostic significance of SGRQ. Methods: In this prospective observational study conducted between May 2012 and August 2018, we evaluated 269 enrolled patients with MAC-PD and examined associations between baseline SGRQ total scores and mortality or clinical variables (anchors), including serum C-reactive protein levels and pulmonary function test results. Results: Age- and sex-matched SGRQ scores indicated significantly greater impairment in patients with MAC-PD than in the general population ( P < 0.001). On multivariable Cox proportional hazards regression analysis, the SGRQ total score ≥25 was an independent risk factor for mortality (adjusted hazard ratio, 5.90; 95% confidence interval, 1.65–37.7) as well as age, body mass index, and forced vital capacity (FVC). Mixed-effect model results showed a significant association between SGRQ symptom/total scores and forced expiratory volume in 1 s (FEV1 ), FVC, and diffusing carbon monoxide capacity. Older age, a positive smear, non-nodular/bronchiectatic form, and cavity regions were associated with SGRQ total score deterioration. Patients with a greater decline from baseline FEV1 (% predicted) exhibited significantly worse impairment in the SGRQ total score (mean ± SE, 4.69 ± 10.9 points, P = 0.001). Conclusions: SGRQ showed longitudinal validity in assessing disease severity and was sensitive to changes in patients with MAC-PD, especially changes in %FEV1. The SGRQ total score may be an important prognostic factor. Highlights: We investigated the longitudinal validity of SGRQ scores in patients with MAC-PD. Changes in PFTs were significantly associated with those in SGRQ scores. Older age, smear+, non-NB form, and cavity predicted the decline of SGRQ scores. The SGRQ total score ≥25 was an independent risk factor for mortality.