Quality of life in COPD - does hyperinflation matter?

Abstract

<b>Background:</b> COPD is a debilitating disease and a leading cause of death worldwide. The severity of airflow limitation alone is not strongly correlated with quality of life (QoL) and exercise testing is employed to measure functional performance objectively which is generally believed to impact QoL <b>Aim:</b> Understand how hyperinflation affects QoL <b>Methods:</b> Single-centre, prospective study among COPD patients referred to the lung function laboratory between January and December 2019. Study protocol was reviewed by the Ethics Committee. Stable patients with hyperinflation and air-trapping were characterized by TLC&gt;120%, RV&gt;120% and RV/TLC&gt;120% (group 1) and compared to patients without hyperinflation. We analysed demographic, clinical and functional data. Patients answered symptoms and quality of life questionnaires - modified Medical Research Council (mMRC) dyspnoea scale, COPD Assessment Test (CAT), COPD Clinical Questionnaire (CCQ). <b>Results:</b> 124 patients: 87% men, mean age 66±9years. Group 1 (hyperinflated patients) had lower FEV1 (p&lt;0.01) and IC/TLC (p&lt;0.05) with 32% having IC/TLC ≤ 0.25 in this group. TLCO and KCO were similar in both groups. Considering symptoms and QoL, mMRC and CCQ were significantly higher in patients with hyperinflation (p&lt;0.01 and p₌0.03) and no difference in CAT was found between groups, although a correlation was found between CAT and RV% and CAT and RV/TLC (0.232 and 0.248, p&lt; 0.01). 43% of the hyperinflated patients had mMRC≥2 versus 24% in non-hyperinflated patients (p₌0.02). Regarding CCQ, 53% of hyperinflated patents had CCQ ≥1.5 and only 34% of non-hyperinflated COPD achieved that cut-off (p₌0.03) <b>Conclusion:</b> Hyperinflation and air-trapping in COPD are associated with more symptoms and worse QoL