The Medical Research Council dyspnea scale in the estimation of disease severity in idiopathic pulmonary fibrosis.
BACKGROUND
Medical Research Council (MRC) chronic dyspnea scale, used for the estimation of disability due to dyspnea, may serve as a simple index of disease severity and extent in patients with idiopathic pulmonary fibrosis (IPF). However, its relationship with other commonly used measures has not been evaluated.


METHODS
The association of MRC chronic dyspnea scale with lung function indices and high-resolution computerized tomography (HRCT) scores such as the total interstitial disease score (TIDs) and the fibrosis score (Fs) was examined in 26 untreated patients with IPF sequentially recruited over a period of 3 years. The aim of this observational study was to explore the relationship between dyspnea, impairment of lung function and CT estimation of disease severity in patients with IPF.


RESULTS
The MRC dyspnea score was significantly associated with FVC, FEV1, TLC, DLCO, PaO2, and PaCO2 and with both HRCT scores. In multiple regression analysis only the FVC (OR = 0.85, 95% CI = 0.75-0.95, P = 0.004) and PaCO2 (OR = 0.69, 95% CI = 0.50-0.95, P = 0.02) correlated with dyspnea. Furthermore, both TIDs and Fs were negatively associated with FVC, FEV1, TLC and PaO2. In multiple regression analysis only the FVC correlated with both TIDs (r2 = 0.57, P = 0.0001) and Fs (r2 = 0.46, P = 0.0005).


CONCLUSIONS
These observations suggest that the MRC dyspnea scale could offer useful information about the estimation of severity in patients with IPF. Furthermore among functional indices the FVC seems to be the best estimator of disease severity and extent.
Papiris
Spyros A
SA
Department of Critical Care and Pulmonary Services, National and Capodistrian University of Athens, Evangelismos Hospital, 45-47 Ipsilantou Street, Athens 10675, Greece. papiris@otenet.gr
Daniil
Zoe D
ZD
Malagari
Katerina
K
Kapotsis
Giorgos E
GE
Sotiropoulou
Christina
C
Milic-Emili
Joseph
J
Roussos
Charis
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D004417:Dyspnea / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008176:Lung Volume Measurements; D008297:Male; D008875:Middle Aged; D011658:Pulmonary Fibrosis / Q000150:complications* / Q000175:diagnosis*; D012044:Regression Analysis; D012129:Respiratory Function Tests; D012680:Sensitivity and Specificity; D012907:Smoking; D011795:Surveys and Questionnaires