Emphysema on imaging is associated with quality of life in elderly patients with chronic obstructive pulmonary disease.
BACKGROUND
Limited data are available on the association between the severity of emphysema or airway narrowing, and health-related quality of life (HRQOL) in patients with chronic obstructive pulmonary disease (COPD), which has been seen to be more prevalent among elderly subjects. The aim of this study was to examine the association between HRQOL, physical parameters and structural alterations in lung of COPD patients.


METHODS
Stable COPD patients (n = 125; mean age 71.0) were studied. Both the severity of emphysema, which was expressed as the extent of the low-attenuation area (LAA%), and percentage of the large airway wall area (WA%) on high-resolution computed tomography (HRCT) were compared with various parameters of the generic and HRQOL, respectively, together with pulmonary function tests and exercise capacity.


RESULTS
The predicted value of forced expiratory volume in 1 s was significantly associated with both LAA% and WA%, but the diffusion capacity was strongly correlated with LAA% alone. Parameters of the generic and HRQOL, and almost all other parameters appeared to be significantly associated with LAA% alone, whereas no association was observed between WA% and QOL.


CONCLUSIONS
We concluded that the severity of emphysema, but not that of large airway narrowing on HRCT, is associated with both generic and health-related QOL and reduced diffusion capacity. This notion might provide useful information in practice among elderly subjects who are unable to perform a spirometry.
Motohashi
Norihisa
N
Department of Pulmonary Medicine, Infection and Oncology, The Respiratory Care Clinic, Nippon Medical School, Tokyo, Japan.
Kimura
Kazuyoshi
K
Ishii
Takeo
T
Wakabayashi
Ritsuko
R
Kurosaki
Hiroko
H
Motegi
Takashi
T
Yamada
Kouichi
K
Jones
Rupert C M
RC
Gemma
Akihiko
A
Kida
Kozui
K
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000000981:diagnostic imaging*; D011656:Pulmonary Emphysema / Q000150:complications / Q000000981:diagnostic imaging*; D011788:Quality of Life; D012129:Respiratory Function Tests; D036542:Tomography, Spiral Computed