Background and objective: Forced respiratory volume in first second spirometry is currently used to diagnose chronic obstructive pulmonary disease. However, this technique does not always provide a reliable short-term prognosis, especially in patients with associated morbidity. We propose that specific health-related quality of life questionnaires are a better tool to estimate the prognosis of chronic obstructive pulmonary disease.
Patients and method: A total of 93 patients who had been admitted to Unit 1 of the Department of Internal Medicine at the Reina Sofia Hospital for chronic obstructive pulmonary disease exacerbation were followed up for one year after discharge. The number of hospital readmissions were recorded. A prospective cohort design and logistic regression analysis were used.
Results: Mean age was 70.8, 83% were males, 89.2% presented with an associated illness, and 59.1% had been hospitalized previously. The mean forced respiratory volume in first second was 34% and the overall score for the St George's Respiratory Questionnaire was 58.2. After one year, 40.4% of patients were readmitted to hospital. The regression model included scores for the St George's Respiratory Questionnaire activity scale (OR 1.05) and long-term home oxygen therapy (OR 5.18).
Conclusions: The St George's Respiratory Questionnaire score better predicts hospital readmission after one year than the forced respiratory volume in first second. The activity scale is the best predictor of readmission. Long-term home oxygen therapy is associated with an increase in the number of hospitalizations.