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COMPARING QUALITY OF LIFE IN ADEQUATELY AND INADEQUATELY OXYGENATED PATIENTS WITH EXERTION WITH VARYING PULMONARY DISEASES: A RETROSPECTIVE REVIEW

      TOPIC: Respiratory Care
      TYPE: Original Investigations
      PURPOSE: The primary aim of this study was to compare the quality of life (QoL) between: 1) adequately oxygenated (SpO2 88% and above) and inadequately oxygenated (SpO2 < 88%) patients with exertion, and 2) patient disease state. A secondary aim attempted to determine the contribution of several patient demographic and 6-minute walk test variables to quality of life as measured by the St. George Respiratory Questionnaire (SGRQ) symptom, activity, life impact, and total scores among patients presenting to a pulmonary rehab program.
      METHODS: All patient charts from Piedmont Pulmonary and Sleep Medicine's pulmonary rehabilitation program from 2013-2017 (n=421), which contained a satisfactorily completed SGRQ and a 6-minute walk test, were retrospectively analyzed. Patients were classified by the following disease states: 1) asthma (n=23), 2) bronchiectasis (n=6), 3) interstitial lung disease (n=58) including patients with idiopathic pulmonary fibrosis, pulmonary fibrosis, sarcoidosis, and cryptogenic organizing pneumonia, 4) primary pulmonary hypertension (n=7), 5) restrictive lung disease (n=4), 6) stage 2 COPD (n=115), 7) stage 3 COPD (n=129), 8) stage 4 COPD (n=49), and 9) other (n=30) which included patients with chronic respiratory failure with hypoxia, lung cancer, structural emphysema, lung transplantation, and dyspnea. Correlation coefficients were calculated between each of the SGRQ categories and patient oxygenation state. Stepwise regression was used to determine the contribution of 6-minute walk test distance, supplemental O2 flowrate, age, gender, pulmonary disease process, highest reported Borg score (dyspnea) with exertion, and nadir SpO2 with exertion to QoL.
      RESULTS: No significant correlations existed between patient oxygenation state (adequately [n=264] or inadequately [n=157]) and the symptom, activity, life impact, or total SGRQ scores. Similarly, no significant correlations were noted between patient disease state and the various SGRQ scores. The main contributors to variation in SGRQ total score were highest reported Borg score (dyspnea), patient age, 6-minute walk test distance, and nadir SpO2 (totaling 25.3% variation) with the highest reported Borg score accounting for the largest variation among these parameters at 14.2%.
      CONCLUSIONS: Neither the adequacy of oxygenation or pulmonary disease state showed significant correlations with either symptom, activity, life impact or total SGRQ scores. The highest reported Borg score (dyspnea) accounts for the largest single contributor to total SGRQ score.
      CLINICAL IMPLICATIONS: Pulmonologists might be better served to emphasize a patient's highest reported Borg score with exertion for those patients who are inadequately oxygenated (and, thus, qualify for supplemental oxygen) when determining what type of oxygen delivery system that patient should use.
      DISCLOSURES: No relevant relationships by Alyssa LaForme Fiss, source=Web Response
      No relevant relationships by Chad Miller, source=Web Response, value=Consulting fee
      Removed 04/27/2021 by Chad Miller, source=Web Response
      No relevant relationships by Chad Miller, source=Web Response, value=Honoraria
      Removed 04/27/2021 by Chad Miller, source=Web Response
      No relevant relationships by Chad Miller, source=Web Response, value=Honoraria
      Removed 04/27/2021 by Chad Miller, source=Web Response
      No relevant relationships by Adam Tahlor, source=Web Response
      No relevant relationships by Timothy Washburn, source=Web Response