Evaluation of respiratory impairment and health related quality of life in pulmonary tuberculosis sequelae patients
Keywords:Pulmonary tuberculosis sequelae, SGRQ total score, Radiological score
Background: Pulmonary tuberculosis is a common disease that can result in residual anatomical and functional changes despite microbiological cure. But the ideal method to identify and evaluate persons with pulmonary impairment after tuberculosis and its impact on population health are unknown. Hence the study was conducted with the aim of the present study was to Evaluate the respiratory and cardiac impairment and to assess the health related quality of life in pulmonary tuberculosis sequelae patients.
Methods: This observational study was conducted on 200 patients randomly at the Institute of thoracic medicine at Chetpet and Rajiv Gandhi government general hospital, Chennai during a period of 6 months from April 2013 to October 2013. All patients were investigated for sputum for acid fast Bacillus, chest skiagram, spirometry, electrocardiogram, echo, six minute walk test and St. George respiratory questionnaire.
Results: In this study, spirometry abnormalities were present in 81% of patients. No significant correlation observed between smoking index and pulmonary function abnormality (0.145). However, moderate correlation was seen between radiology and pulmonary function abnormality (0.307). 98% of the patients showed diminished exercise capacity. The prevalence of corpulmonale was increased with the degree of radiological impairment progress from grade 1 to 3 with a moderate correlation (0.385). No significant correlation (0.198) was noticed between the parameters smoking index and exercise capacity. The overall SGRQ scores mean (SD) were 54±11.5, 41.7±24.7, 28.9±19.6 and 37.0±19.1 for the symptom, activity, impact and overall scales respectively. No significant relationship was noticed between smoking index and SGRQ total score (p=0.512).
Conclusions: The present study confirms that there is significant functional limitation in pulmonary sequelae, addressing the need of pulmonary rehabilitation for better quality of life. Smoking cessation therapy all can improve their quality of life after pulmonary impairment. Cardiac evaluation must be done in all post tuberculosis patients to rule out corpulmonale.
Machida K, Maekura R. State of the art: sequelae of tuberculosis. Kekkaku. 2005;80(10):655-74.
Pasipanodya JG, Miller TL, Vecino M. Pulmonary impairment after tuberculosis. Chest. 2007;131:1817-24.
American Thoracic Society; American College of Chest Physicians. ATS/ACCP Statement on cardiopulmonary exercise testing. Am J Respir Crit Care Med. 2003 Jan 15;167(2):211-77.
Di Naso FC, Pereira JS, Schuh SJ, Unis G. Functional evaluation in patients with pulmonary tuberculosis sequelae. Rev Port Pneumol. 2011;17(5):216-21.
Ramosi LMM, Sulmonett N, Ferreira III CS, HenriquesIV JF, de Miranda SS. Functional profile of patients with tuberculosis sequelae in a university hospital. J Bras Pneumol. 2006;32(1):43-7.
Banurekha VV, Ramachandran R, Kuppu Rao KV, Rahman F, Adhilakshmi AR, Kalaiselvi D, et al. Assesment of longterm status of sputum positive pulmonary TB patients successfully treated with short course chemotherapy. Indian J Tuberculosis. 2009;56;132-40.