Published: 2018-05-22

Assessment of the correlates of respiratory morbidity related quality of life, using St George Respiratory Questionnaire (SGRQ) among male COPD patients

Vikas Dogra, Balakrishnan Menon, Vishal Bansal, Shailendra Nath Gaur


Background: COPD is ranked eighth among the top 20 conditions causing disability globally. Assessment in subjective areas such as dyspnea and HRQL provides complementary information to physiologic measurements. Lower Health-Related Quality of Life has been associated with mortality and morbidity in COPD.

Methods: The study was conducted at the Department of Respiratory Medicine and at Vallabhbhai Patel Chest Institute and the associated, Vishwanathan Chest Hospital, University of Delhi. Between September 2012 to August 2013. We conducted present study on 40 male COPD subjects aged more than 45 years, divided into 4 groups based on CT phenotype as normal, Airway Dominant (AD), Emphysema Dominant (ED) and mixed types.  We compared the St. George Respiratory Questionnaire scores, 6 Minutes’ walk Distance scores, Clinical parameters, Spirometry indices across these phenotypes.   

Results: The mean SGRQ score in present study was 54.07 ± 17.24 (Range :17.3 to 84.57). The Mean 6MWD in present study was 434.58 ± 125.47 metres. The significant parameters which had correlation with SGRQ total score were Age (r=0.343, p = 0.03), 6MWD (-0.397, p = 0.011), FEV1 /FVC (0.499, p< 0.001), DLCO (-0.601, p <0.001), Low attenuation areas in CT (0.606, p< 0.001). 

Conclusions: 6MWD, FEV1/FVC, age, Low attenuation areas in CT, DLCO had an influence on the quality of life as measured by SGRQ scores in present study. Therapeutic approaches to improve the quality of life in COPD should take these indices into consideration.


Chronic obstructive pulmonary disease (COPD), CT phenotype, Health-related quality of life (HRQL), Morbidity, St George's Respiratory Questionnaire (SGRQ)

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Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388:1545-602.

Vestbo J, Hurd SS, Rodriguez-Roisin R. [An overview of Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease (GOLD) (revised 2011)]. Zhonghua Yi Xue Za Zhi. 2012;92:937-8.

Fletcher C, Peto R. The natural history of chronic airflow obstruction. Br Med J. 1977;1:1645-8.

Halbert RJ, Natoli JL, Gano A, Badamgarav E, Buist AS, Mannino DM. Global burden of COPD: systematic review and meta-analysis. Eur Respir J. 2006;28:523-32.

Rycroft CE, Heyes A, Lanza L, Becker K. Epidemiology of chronic obstructive pulmonary disease: a literature review. Int J Chron Obstruct Pulmon Dis. 2012;7:457-94.

Jindal SK, Aggarwal AN, Gupta D, Agarwal R, Kumar R, Kaur T, et al. Indian study on epidemiology of asthma, respiratory symptoms and chronic bronchitis in adults (INSEARCH). Int J Tuberc Lung Dis. 2012;16:1270-7.

McKay AJ, Mahesh PA, Fordham JZ, Majeed A. Prevalence of COPD in India: a systematic review. Prim Care Respir J. 2012;21:313-21.

Ley-Zaporozhan J, Ley S, Kauczor HU. Morphological and functional imaging in COPD with CT and MRI: present and future. Eur Radiol. 2008;18:510-21.

Coxson HO, Rogers RM. Quantitative computed tomography of chronic obstructive pulmonary disease. Acad Radiol. 2005;12:1457-63.

Falaschi F, Miniati M, Battolla L, Filippi E, Sostman HD, Laiolo E, et al. [Quantification of pulmonary emphysema with computerized tomography. Comparison with various methods]. Radiol Med. 1995;90:16-23.

Anthonisen NR, Wright EC, Hodgkin JE. Prognosis in chronic obstructive pulmonary disease. Am Rev Respir Dis. 1986;133:14-20.

Pauwels RA, Buist AS, Calverley PM, Jenkins CR, Hurd SS. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary. Am J Respir Crit Care Med. 2001;163:1256-76.

Domingo-Salvany A, Lamarca R, Ferrer M, Garcia-Aymerich J, Alonso J, Felez M, et al. Health-related quality of life and mortality in male patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2002;166:680-5.

Engstrom CP, Persson LO, Larsson S, Sullivan M. Health-related quality of life in COPD: why both disease-specific and generic measures should be used. Eur Respir J. 2001;18:69-76.

Seemungal TA, Donaldson GC, Paul EA, Bestall JC, Jeffries DJ, Wedzicha JA. Effect of exacerbation on quality of life in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1998;157:1418-22.

Ferrer M, Villasante C, Alonso J, Sobradillo V, Gabriel R, Vilagut G, et al. Interpretation of quality of life scores from the St George's Respiratory Questionnaire. Eur Respir J. 2002;19:405-13.

Chen LF, Wang CH, Chou PC, Ho SC, Joa WC, Sheng TF, et al. Association Between Emphysema Score, Six-Minute Walk and Cardiopulmonary Exercise Tests in COPD. Open Respir Med J. 2012;6:104-10.

Jones PW, Harding G, Berry P, Wiklund I, Chen W-H, Kline Leidy N. Development and first validation of the COPD Assessment Test. Eur Respir J. 2009;34:648-54.

Meguro M, Barley EA, Spencer S, Jones PW. Development and Validation of an Improved, COPD-Specific Version of the St. George Respiratory Questionnaire. Chest. 2007;132:456-63.

Barnes PJ. Chronic obstructive pulmonary disease: effects beyond the lungs. PLoS Med. 2010;7:e1000220.

Barnes PJ, Celli BR. Systemic manifestations and comorbidities of COPD. Eur Respir J. 2009;33:1165-85.

Van Stel HF, Bogaard JM, Rijssenbeek-Nouwens LH, Colland VT. Multivariable assessment of the 6-min walking test in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2001;163:1567-71.

Marti S, Munoz X, Rios J, Morell F, Ferrer J. Body weight and comorbidity predict mortality in COPD patients treated with oxygen therapy. Eur Respir J. 2006;27:689-96.

Osman IM, Godden DJ, Friend JA, Legge JS, Douglas JG. Quality of life and hospital re-admission in patients with chronic obstructive pulmonary disease. Thorax. 1997;52:67-71.

Obaseki DO, Erhabor GE, Awopeju OF, Obaseki JE, Adewole OO. Determinants of health related quality of life in a sample of patients with chronic obstructive pulmonary disease in Nigeria using the St. George's respiratory questionnaire. African Health Sciences. 2013;13:694-702.

Dourado VZ, Antunes LCO, Carvalho LR, Godoy I. Influence of general clinical parameters on the quality of life of chronic obstructive pulmonary disease patients. J Brasil pneumol. 2004;30:207-14.