Health-related quality of life in hypercapnic COPD patients during an admission for acute exacerbation

Introduction Little is known about Health Related Quality of Life (HR-QoL) during an admission in COPD patients with chronic hypercapnic respiratory failure (CHRF) after an episode of ventilation for acute exacerbation. The Maugeri Respiratory Failure (MRF-28) and Severe Respiratory Insufficiency (SRI) questionnaires were specifically developed for patients with stable CHRF. Methods Hospitalized patients still hypercapnic > 48 hours after ending mechanical (invasive or non inasive) ventilation filled in the SRI, MRF-28 and Chronic Respiratory Questionnaire (CRQ), Groninger Activity Restriction Scale (GARS) and Hospital Anxiety and Depression Scale (HADS). Concurrent validity was evaluated by comparing both questionnaires with the CRQ. Construct validity was determined by assessing correlations between the different domains of the MRF-28, SRI, CRQ and both generic physical and psychological questionnaires measured during admission. Results N= 163 COPD patients (67 men; age 63 yrs; FEV1 0.67L±0.26). Total scores and all domains of MRF-28 and SRI correlated (p<0.01) with the CRQ and with its respective domains. Physical domains of all 3 questionnaires correlated strongly with the GARS (r=0.77, 0.74 and 0.52, respectively) and psychological domains of the SRI and CRQ with the HADS (r=0.79 and 0.76). Conclusions This study shows that SRI and MRF-28 are valid questionnaires in hospitalized patients with CHRF who are still hypercapnic 48 hours after ending mechanical ventilation for an acute COPD exacerbation. As the SRI is more elaborate with also a psychological domain we recommend this questionnaire in this specific group of severe COPD patients.