Quality of life and physical working capacity in pulmonary sarcoidosis

Abstract

Objective To study the quality of life (QOL) and physical working capacity (PWC) in patients with pulmonary sarcoidosis. Materials and methods. Eighty patients with pulmonary sarcoidosis were examined (mean age 35 (39; 45) years), including 43 men (53.8 %) and 37 women (46.3 %). The duration of sarcoidosis was 3 (2; 4) years. Seventy-five percent of patients had pathologically proven sarcoidosis. All patients completed the SF-36 questionnaire; physical examination, chest computed tomography, spirometry and cardiopulmonary exercise testing (CPET) were conducted. PWC was determined according to the peak oxygen uptake (VO 2 peak) via CPET. Results. 29 (36,3%) patients had reduction of QOL (psychological and physical components of health). The most significant decrease of QOL was noted on the scale «general health» — 67 (47; 77) scores, «mental health» — 72 (54; 84) scores and «vitality» — 72.5 (50; 82.5) scores. Female patients (p=0.008) over 40 years of age (p=0.044) with clinically significant symptoms (p=0.012) and comorbidities (p=0.049) had a lower QOL. Patients with high or low QOL did not have differences in radiology stages, laboratory test results and lung function parameters. The female sex (OR 3.26, 95 % CI 1.15–9.23; p=0.026) and the clinical manifestations of sarcoidosis (OR 3.63, 95 % CI 1.06–15.47; p=0.041) were the independent factors of low QOL. Pulmonary sarcoidosis patients with exercise intolerance had the most significant reduction of the physical (p=0.037) and psychological components of health (p=0.033). Conclusion. Factors of QOL reduction in patients with sarcoidosis were female sex and clinically significant pulmonary sarcoidosis. In patients with low QOL, CPET can be used to determine the PWC and mechanisms of its reduction. The presented diagnostic algorithm will optimize the choice of therapy for patients with sarcoidosis.