Association of Ventilatory Disorders with Respiratory Symptoms, Physical Activity, and Quality of Life in Subjects with Prior Tuberculosis: A National Database Study in Korea.

Bumhee Yang,Hayoung Choi,Hyun Lee,Ji-Yong Moon,Youlim Kim,Sun Hye Shin,Hye Yun Park

doi:10.3390/jpm11070678

Abstract

Tuberculosis (TB) survivors experience post-TB lung damage and ventilatory function disorders. However, the proportions of obstructive and restrictive ventilatory disorders as well as normal ventilation among subjects with prior TB are unknown. In addition, the impacts of ventilatory disorder and its severity on respiratory symptoms, physical activity limitations, and the quality of life in subjects with prior TB remain unclear. Subjects who participated in the Korean National Health and Nutritional Examination Survey 2007–2016 were enrolled in this study. We evaluated the impact of each ventilatory disorder and its severity on respiratory symptoms, physical activity limitations, and quality of life (measured by the EuroQoL five dimensions questionnaire [EQ-5D] index values) in subjects with prior TB. Among 1466 subjects with prior TB, 29% and 16% had obstructive ventilatory disorders and restrictive ventilatory disorders, respectively. Mild and moderate obstructive ventilatory disorders were not associated with respiratory symptoms, physical activity limitations, or EQ-5D index value compared with normal ventilation; however, severe obstructive ventilatory disorders were associated with more respiratory symptoms (adjusted odds ratio [aOR] = 13.62, 95% confidence interval [CI] = 4.64–39.99), more physical activity limitation (aOR = 218.58, 95% CI = 26.82–1781.12), and decreased EQ-5D index (adjusted coefficient = −0.06, 95% CI = (−0.12–−0.10) compared with normal ventilation. Mild restrictive ventilatory disorders were associated with more respiratory symptoms (aOR = 2.10, 95% CI = 1.07–4.14) compared with normal ventilation, while moderate (aOR = 5.71, 95% CI = 1.14–28.62) and severe restrictive ventilatory disorders (aOR = 9.17, 95% CI = 1.02–82.22) were associated with physical activity limitation compared with normal ventilation. In conclusion, among subjects with prior TB, 29% and 16% developed obstructive and restrictive ventilatory disorders, respectively. Severe obstructive ventilatory disorder was associated with more respiratory symptoms, more physical activity limitation, and poorer quality of life, while severe restrictive ventilatory disorder was associated with more physical activity limitations.

Highlights

Tuberculosis (TB) is the leading cause of death from a single epidemic disease worldwide [1]
This study investigated the impact of each ventilatory disorder and its severity on respiratory symptoms, physical activity limitations, and quality of life (QoL) among subjects with prior TB
The proportion of males was highest in subjects with obstructive ventilatory disorders, followed by those with restrictive ventilatory disorders and those with normal ventilation (76.2%, 52.0%, and 49.5%, respectively, p < 0.001)

Summary

Introduction

Tuberculosis (TB) is the leading cause of death from a single epidemic disease worldwide [1]. The ventilatory disorders of subjects with prior TB comprise obstructive and restrictive patterns [8]. Obstructive ventilatory disorder, which appears as airflow limitation on pulmonary function tests, is the most well-known form of lung damage after TB treatment [5,8]. Post-TB lung damage, including cavity, bronchiectasis, or distorted airway, can cause obstructive ventilatory disorder, which can lead to dyspnea, chronic obstructive pulmonary disease, and reduced exercise capacity [9,10]. Obstructive disorder has been recognized as post-TB lung damage, restrictive ventilatory disorder is found in subjects with prior TB and can lead to dyspnea or chest pain [11]. The impacts of ventilatory defects and severity of defects on respiratory symptoms, physical limitations, and QoL in subjects with prior TB have not been investigated

Methods

Results

Discussion

Conclusion