Background In patients hospitalised with acute exacerbations of COPD (AECOPD), quality of life (QoL) scores have been associated with subsequent mortality and readmission. We have investigated which of several QoL indices are most closely related to subsequent outcome.
Methods 183 patients with AECOPD surviving to hospital discharge were identified prospectively. Baseline clinical information and subsequent mortality and readmission over 12 months were recorded. QoL was assessed at discharge using: the St. George’s Respiratory Questionnaire (SGRQ); the Chronic Respiratory Questionnaire (CRQ); the Hospital Anxiety and Depression Scale (HADS); and the Nottingham Extended Activities of Daily Living Scale (NEADL) and relationships between QoL and each outcome were analysed.
Results Mean (SD) age was 69.0 (9.0) years and most patients: were female (58.5%); had severe airflow obstruction (mean (SD) FEV1 40.2 (17.3) % predicted); and were of normal weight (mean (SD) BMI 26.2 (7.0) kgm2).
130 (71%) patients were readmitted during the year following discharge, with a median number of readmissions of 1 (IQR 0 to 3; range 0 to 15). The mortality rates at 3, 6 and 12 months following discharge were 6.6%, 10.4% and 18.0% respectively.
Self-reported measures of activity (SGRQ Activity and NEADL) were the only QoL indices significantly associated with both mortality and readmission. The relations of SGRQ Impacts and HADS Depression to mortality showed nonsignificant trends, but no other QoL domains were associated with readmission (table 1).
Conclusion Measures of self-reported activity at discharge were the most closely associated with both subsequent mortality and readmission and are likely to be the most useful of the QoL indices studied for predicting clinical outcome.