Correlates of mortality in elderly COPD patients: Focus on health-related quality of life

Background and objective: The Saint George Respiratory Questionnaire (SGRQ) is widely used as a measure of health-related quality of life (HRQL) in patients with COPD. This study tested whether the SGRQ predicts the survival of patients with COPD. Methods: The study recruited 238 patients with COPD who were participants in the multicentre Salute Respiratoria nell'Anziano (Sa. R. A.) study. Patients' sociodemographic, clinical and functional characteristics were assessed and the association between the SGRQ and mortality, corrected for potential confounders, was estimated. Results: The mean age of study participants was 72.6 years. Over the 5-year observation period there were 88 deaths. After adjustment for potential confounders, the SGRQ score was associated with an increased risk of dying (hazard ratio (HR): 1.22 for four-point increments; 95% confidence interval (CI): 1.02-1.45). There was no association between mortality and the Symptoms subscale (corrected HR: 1.13; 95% CI: 0.96-1.32), whereas each four-point increment of the Activity (HR: 1.20; 95% CI: 1.00-1.43) and Impact (HR: 1.38; 95% CI: 1.03-1.83) subscale scores were associated with increased mortality. Higher FEV1 relative to predicted (HR: 0.73 for each 5% increment; 95% CI: 0.58-0.91) and better performance at the 6-min walking test relative to predicted (HR: 0.93 for each 5% increment; 95% CI: 0.89-0.97) were associated with lower mortality. Conclusions: In elderly COPD patients, the SGRQ can improve prognostic models based on classical indicators of disease severity.