2004 |
Gee3333 Gee L, Abbott J, Hart A, Conway SP, Etherington C, Webb AK. Associations between clinical variables and quality of life in adults with cystic fibrosis. J Cyst Fibros 2005;4(1):59–66.
|
Self-administered questionnaire by mail |
NR |
- |
CF non-transplanted patients |
- |
|
|
The median values (25th percentile-75th percentile) if CFQoL domains of patients not on the waiting list (n = 196), on the waiting list (n = 13) and post-transplant (n = 14)
Not on waiting list: physical functioning 91 (76–98), social functioning 95 (80–100), treatment issues 80 (60–93), chest symptoms 70 (50–90), emotional functioning 85 (67–92), concerns for the future 43 (26–62), interpersonal relationships 66 (46–80), body image 66 (46–86), career issues 60 (40–85)
Waiting list: physical functioning 66 (55–75), social functioning 70 (52–90), treatment issues 53 (40–70), chest symptoms 50 (30–70), emotional functioning 75 (48–87), concerns for the future 33 (21–61), interpersonal relationships 52 (39–74), body image 60 (36–73), career issues 35 (27–62)
Post-transplant: physical functioning 96 (92–100), social functioning 95 (93–100), treatment issues 96 (91–100), chest symptoms 100 (77–100), emotional functioning 91 (82–98), concerns for the future 51 (25–66), interpersonal relationships 62 (39–74), body image 66 (45–75), career issues 37 (33–75)
Multiple linear regression analysis using beta estimates (95% CI) was utilised to demonstrate that post-transplant status was correlated with HRQoL. In the CFQoL domains most related to functional health status: physical functioning 8.2 (−0.93, 14), social functioning 7.3 (−0.36, 13), treatment issues 16 (6.0, 23) and chest symptoms 20 (10.28), patients reported a much higher HRQoL post lung transplantation.
|
2004 |
Vermeulen2727 Vermeulen KM, Ouwens J-P, van der Bij W, de Boer WJ, Koëter GH, TenVergert EM. Long-term quality of life in patients surviving at least 55-months after lung transplantation. Gen Hosp Psychiatry 2003;25(2):95–102.
|
Self-administered questionnaires sent by mail |
Every 3-months while on the waitlist. On admission to waitlist, at 1-months, 4-months, 7-months and 6-monthly thereafter until 31-months post-Lung transplantation |
- |
Patients with other diagnoses (non-CF) |
Compared to months 4, 7, 19, 31, 43, and 55 post-transplant |
|
|
When compared to the general population reference value, before undergoing a lung transplantation, CF patients had significantly worse HRQoL in the NHP domains: mobility (p < 0.001) and energy (p = 0.001). On the other hand, the non-CF patients had significantly worse HRQoL in the NHP domains (p < 0.03): energy, sleep, social (isolation) and emotional (reaction). Between 1- to 4-months after transplantation, when compared to non-CF patients, CF patients experienced significantly greater HRQoL in the NHP domains: mobility (p < 0.001) and energy (p = 0.003). There was no significant difference between NHP domains (p > 0.05): pain, sleep, social (isolation) and emotional (reaction). 4-months after transplantation, when compared to non-CF patients, CF patients experienced significantly greater HRQoL in the NHP domain: mobility (p = 0.03). There was no significant difference between the NHP domains: pain, energy, sleep, social (isolation) and emotional (reaction). At 7-months (p = 0.03) and 13-months (p = 0.01) post transplantation, CF patients experienced significantly greater HRQoL in the NHP domain: sleep, but there was no significant difference between the NHP domains: mobility, pain, energy, social (isolation) and emotional (reaction).
NHP scores (median (range) for CF vs. non-CF for time periods: Before Lung transplantation, 1-month, 4-months, 7-months, and 13-months across all domains)
Mobility: CF: 33 (0–79) vs. non-CF: 57 (10–89), CF: 22 (0–60) vs. non-CF: 22 (0–88), CF: 0 (0–0) vs. non–CF: 0 (0–57) (p = 0.03), Mobility: CF: 0 (0–0) vs. non–CF: 0 (0–35), Mobility: CF: 0 (0–11) vs. non–CF: 0 (0–57)
Pain: CF: 0 (0–57) vs. non–CF: 0 (0–91), Pain: CF: 0 (0–13) vs. non–CF: 10 (0–67), Pain: CF: 0 (0–0) vs. non–CF: 0 (0–72), Pain: CF: 0 (0–0) vs. non–CF: 0 (0–94), Pain: CF: 0 (0–17) vs. non–CF: 0 (0–84)
Energy: CF: 61 (0–100) vs. non–CF: 100 (0–100), Energy: CF: 0 (0–61) vs. non–CF: 0 (0–100), Energy: CF: 0 (0–0) vs. non–CF: 0 (0–100), Energy: CF: 0 (0–0) vs. non–CF: 0 (0–63), Energy: CF: 0 (0–39) vs. non–CF: 0 (0–100)
Sleep: CF: 13 (0–100) vs. non–CF: 14 (0–100) (p = 0.03), Sleep: CF: 13 (0–35) vs. non–CF: 34 (0–87) (p = 0.03), Sleep: CF: 6 (0–38) vs. non–CF: 13 (0–100), Sleep: CF: 6 (0–13) vs. non–CF: 13 (0–87) (p = 0.03), Sleep: CF: 6 (0–13) vs. non–CF: 13 (0–100) (p = 0.01)
Social (isolation): CF: 0 (0–65) vs. non–CF: 0 (0–100), Social (isolation): CF: 0 (0–22) vs. non–CF: 0 (0–84), Social (isolation): CF: 0 (0–0) vs. non–CF: 0 (0–65), Social (isolation): CF: 0 (0–22) vs. non–CF: 0 (0–65), Social (isolation): CF: 0 (0–22) vs. non–CF: 0 (0–41)
Emotional (reaction): CF: 9 (0–47) vs. non–CF: 14 (0–100), Emotional (reaction): CF: 0 (0–24) vs. non–CF: 4 (0–67), Emotional (reaction): CF: 0 (0–10) vs. non–CF: 0 (0–74), Emotional (reaction): CF: 0 (0–21) vs. non-CF: 0 (0–70), Emotional (reaction): CF: 0 (0–10) vs. non-CF: 0 (0–33)
At 25- and 31-months after transplantation, there was no significant difference between the restrictions on the domains of mobility, pain, energy, sleep, social (isolation) and emotional (reaction). It can be concluded that Lung transplantation has a substantial positive effect on HRQoL in CF and in non-CF patients. HRQoL improved post-transplant, especially the NHP domain of mobility in both groups. CF patients experienced fewer restrictions on several HRQoL domains before transplantation and reached the same level after transplantation compared to non-CF patients may lead to the conclusion that patients with other diagnoses gained more improvement after transplantation compared to CF.
|
2005 |
Smeritschnig2828 Smeritschnig B, Jaksch P, Kocher A, Seebacher G, Aigner C, Mazhar S, et al. Quality of life after lung transplantation: a cross-sectional study. J Heart Lung Transplant 2005;24(4):474–80.
|
Self-administered questionnaire via a study kit given during their check-up visit to the outpatient department |
42 ± 30 months (Range: 3–117 months) |
– |
Normative healthy and chronic lung disease populations and patients with other diagnoses (non-CF) |
– |
|
|
SGRQ (compared to individuals with lung disease)
Symptoms: 21.1 ± 18.5 vs. Reference value: 62.5 ± 15.5 (p < 0.001)
Activity: 36.9 ± 25.0 vs. Reference value: 55.5 ± 24.0 (p < 0.001)
Impacts: 20.7 ± 18.3 vs. Reference value: 37.4 ± 22.5 (p < 0.001)
Total: 24.4 ± 18.3 vs. Reference value: 47.6 ± 19.7 (p < 0.001)
SF-36 domains (compared to healthy reference)
Physical function: 68.6 ± 24.1 vs. Reference value: 85.7 ± 22.1 (p < 0.001)
Role physical: 59.3 ± 41.9 vs. Reference value: 83.7 ± 31.7 (p < 0.001)
Bodily pain: 72.1 ± 28.1 vs. Reference value: 79.1 ± 27.4 (p < 0.05)
General health: 58.9 ± 19.8 vs. Reference value: 68.0 ± 20.1 (p < 0.001)
Vitality: 59.5 ± 21.9 vs. Reference value: 63.3 ± 18.5d (p = NS)
Social function: 82.7 ± 23.1 vs. Reference value: 88.8 ± 18.4 (p < 0.05)
Role emotional: 67.8 ± 43.7 vs. Reference value: 90.3 ± 25.6 (p < 0.001)
Mental health: 71.4 ± 20.7 vs. Reference value: 73.9 ± 16.4 (p = NS)
Physical component summary scale: 43.9 ± 10.1 vs. Reference value: 50.2 ± 10.2 (p < 0.001)
Mental component summary scale: 49.8 ± 11.5 vs. Reference value: 51.5 ± 8.1 (p = NS)
SF-36 domains (compared to healthy reference)
Physical function: 68.6 ± 24.1 vs. Reference value: 85.7 ± 22.1 (p < 0.001)
Role physical: 59.3 ± 41.9 vs. Reference value: 83.7 ± 31.7 (p < 0.001)
Bodily pain: 72.1 ± 28.1 vs. Reference value: 79.1 ± 27.4 (p < 0.05)
General health: 58.9 ± 19.8 vs. Reference value: 68.0 ± 20.1 (p < 0.001)
Vitality: 59.5 ± 21.9 vs. Reference value: 63.3 ± 18.5d (p = NS)
Social function: 82.7 ± 23.1 vs. Reference value: 88.8 ± 18.4 (p < 0.05)
Role emotional: 67.8 ± 43.7 vs. Reference value: 90.3 ± 25.6 (p < 0.001)
Mental health: 71.4 ± 20.7 vs. Reference value: 73.9 ± 16.4 (p = NS)
Compared to a normative, healthy population, patients who undergo lung transplantation have significantly worse SF-36 domain physical function (p < 0.001) but show better vitality and mental health. SGRQ scores improved significantly (p < 0.001) in all domains (symptoms, activity, impacts and total) when comparing post lung transplantation patients with patients with pre-existing lung disease (COPD/emphysema, Fibrosis, Pulmonary vascular disease, and others). CF patients had the highest SF-36 PCS score amongst all other diagnosis, but the difference was not statistically significant upon analysis of variance. Upon exclusion of the ‘other’ diagnostic category, CF patients had the highest SF-36 MCS score, and a statistically significant difference (p = 0.001) was noted between the different diagnoses during analysis of variance. Viewing these results collectively, CF patients appear to have the best HRQoL post lung transplantation.
Diagnosis and quality of life (mean±SD)
SGRQ total scores: COPD/emphysema 26.5 ± 19.3, Fibrosis 34.4 ± 17.3, Pulmonary vascular disease 20.4 ± 13.7, CF 7.2 ± 7.4, Others 16.9 ± 10.5 (p = 0.002)
SF-36 physical component summary scale: COPD/emphysema 41.7 ± 10.1, Fibrosis 39.6 ± 9.8, Pulmonary vascular disease 48.4 ± 7.4, CF 53.9 ± 6.6, Others 49.0±6.5 (not significant)
SF-36 mental component summary scale: COPD/emphysema 48.9 ± 12.3, Fibrosis 48.8 ± 12.3, Pulmonary vascular disease 48.1 ± 10.1, CF 53.4 ± 8.1, Others 58.9 ± 2.9 (p = 0.001)
|
2005 |
Vasiliadis3232 Vasiliadis H-M, Collet J-P, Poirier C. Health-related quality-of-life determinants in lung transplantation. J Heart Lung Transplant 2006;25(2):226–33.
|
Self-administered questionnaire by email + follow up telephone call |
Grouped into 1, 2, 3, 4 and 5 years |
Obstructive airways disease |
|
|
The positivity (increase in scores) of the CF and bronchiectasis group for each domain of SF-36 when compared to the Obstructive Airways Disease (OAD) group was reported. CFB had significantly improved HRQoL scores (p < 0.05) in all domains except for physical function (p > 0.05).
Determinants of the domains of the SF-36, mean effect change relative to OAD (95% CI), (p-value)
Physical function: (p > 0.05)
Role physical: 23 (5, 41), (p < 0.05)
Bodily pain: 32 (15, 50), (p < 0.05)
General health: 18 (5, 32), (p < 0.05)
Vitality: 25 (15, 35), (p < 0.05)
Social function: 37 (21, 53), (p < 0.05)
Role emotional: 30 (11, 48), (p < 0.05)
Mental health: 14 (7, 22) (p < 0.05)
|
2013 |
Copeland3030 Copeland CAF, Vock DM, Pieper K, Mark DB, Palmer SM. Impact of lung transplantation on recipient quality of life: a serial, prospective, multicenter analysis through the first posttransplant year. Chest 2013;143(3):744–50.
|
Questionnaire administered at follow up clinic |
3, 6, 9 and 12-months |
– |
– |
|
|
The SF-36 PCS score increased by 10.9-points on average from baseline (p < 0.0001) when considering all time points post lung transplantation, comparable to the USA population norms. The first 3-months post lung transplantation had the most significant rise in SF-36 PCS scores (p = 0.03). The SF-36 MCS score did not change on average from baseline (p = 0.36) and was far below the US population norm. The SF-36 MCS score plateaued within the first-year post lung transplantation (p = 0.92). Of all lung disease groups (COPD, IPF, other), CF patients had the highest HRQoL prior to lung transplantation, albeit there was no statistically significant difference (p = 0.43, CF = 37.0, COPD = 34.3, IPF = 34.8, other = 32.3). At 1-year post lung transplantation, the difference in HRQoL from baseline in CF patients, who increased by 14.0 points on average, was significantly the greatest when compared with COPD and IPF groups which increased 10.2 and 7.2 points respectively (p = 0.04). |
2014 |
Dębska3434 Dębska G, Cepuch G, Mazurek H. Quality of life in patients with cystic fibrosis depending on the severity of the disease and method of its treatment. Postępy Hig Med Dosw 2014;68:498–502.
|
Questionnaire administered |
3 to 37-months post-transplantation |
Yes |
Patients with CF who are stable (not on the waitlist) |
– |
|
|
Of all 3 groups, the post lung transplantation group had mean scores > 50 in all domains of the CFQoL and had the highest mean CFQoL score in the domains: chest symptoms, treatment issues, emotional functioning and in physical functioning, with the social functioning group also being very high. The lowest HRQoL scores in the post lung transplantation group was reported in the CFQoL domains: career concerns, future concerns, body image and interpersonal relationships. The waitlist group had mean scores < 50 in all CFQoL domains, other than emotional function ing and future concerns. When comparing the post lung transplantation group with the waitlist group and the stable CF group, the treatment domain was significantly higher (p < 0.001).
CFQoL scores (mean ± SD) across domains for post transplantation, waitlist, and stable CF groups
Physical functioning 90.6 ± 8.5, 34.1 ± 22.0, 84.2 ± 15.5
Social functioning 73.0 ± 18.4, 34.8 ± 22.5, 81.1 ± 17.0
Treatment issues 95.3 ± 8.9, 39.8 ± 19.4, 68.1 ± 20.1
Chest symptoms 87.3 ± 12.8, 43.7 ± 19.0, 76.6 ± 15.7
Emotional functioning 56.0 ± 11.8, 55.0 ± 17.6, 77.6 ± 19.6
Future concerns 60.6 ± 13.2, 55.0 ± 20.6, 51.9 ± 19.2
Interpersonal relationships 69.3 ± 17.8, 47.5 ± 14.6, 63.2 ± 23.5
Body image 69.3 ± 17.8, 41.7 ± 23.8, 64.6 ± 23.2
Career concerns 55.0 ± 10.0, 32.0 ± 15.4, 65.3 ± 25.8
Global quality of life 73.9 ± 7.9, 42.6 ± 12.4, 70.8 ± 15.7
Using the Kruskal-Wallis test and Dunn post-hoc test, the CFQoL scores (median [IQR], p-value) were compared across domains. Between the 3 groups, a significant difference (p < 0.05) was identified in the CFQoL domains: physical functioning, social functioning, treatment issues, chest symptoms, emotional functioning, body image, career concerns and global quality of life. No significant difference was identified between the CFQoL domains: future concerns and interpersonal relationships. The post lung transplantation group had significantly higher average scores in all domains when compared to the waitlist group (p < 0.05), with the exceptions of the domains: future concerns and interpersonal relationships.
Comparison of CFQoL scores (p-value, median [IQR]) across domains for post-transplant, waitlist, and stable CF
Physical functioning: p < 0.0011, 91 (82.4, 100), 28 (22, 54), 88 (76, 94)
Social functioning: p < 0.0012, 77.5 (60, 85), 32.4 (15, 50), 85(70,95)
Treatment issues: p < 0.0013, 100 (93.3, 100), 37.3 (20,60), 66.7 (60, 80)
Chest symptoms: p < 0.0014, 100 (100, 100), 45 (30, 55), 80 (65, 85)
Emotional functioning: p = 0.0015, 91.3 (75, 100), 52.5 (40, 70), 77.5 (62.5, 97.5)
Future concerns: p = 0.469, 55 (46.7, 66.7), 40 (36.7, 66.7), 50 (36.7, 70)
Interpersonal relationships: p = 0.057, 65 (52, 70), 44 (36, 58), 66 (44, 78)
Body image: p = 0.0086, 66.7 (53.5, 93.3), 40 (20, 53.3), 66.7 (40, 80)
Career concerns: p = 0.0017, 55 (50, 65), 30 (20, 50), 70 (40, 85)
Global quality of life: p < 0.0018, 74.2 (67.3, 80.8), 38.8 (35.4, 48.8), 73.1 (52.3, 80.4)
p-values for comparison of the CFQoL scores median (IQR) between groups across domains for post-transplant vs. waitlist, post-transplant vs. stable CF, waitlist vs. stable CF
Physical functioning: p < 0.01, p > 0.999, p < 0.01
Social functioning: p = 0.009, p ≥ 0.999, p < 0.001
Treatment issues: p < 0.001, p = 0.020, p = 0.012
Chest symptoms: p < 0.001, p = 0.066, p = 0.002
Emotional functioning: p = 0.001, p = 0.638, p = 0.012
Body image: p = 0.023, p > 0.999, p = 0.023
Career concerns: p = 0.024, p > 0.999, p < 0.001
Global quality of life: p < 0.001, p > 0.99, p < 0.001
|
2015 |
Singer3131 Singer LG, Chowdhury NA, Faughnan ME, Granton J, Keshavjee S, Marras TK, et al. Effects of recipient age and diagnosis on health-related quality-of-life benefit of lung transplantation. Am J Respir Crit Care Med 2015;192(8):965–73.
|
Questionnaire at routine clinic visits |
3 to 12-months post-transplant |
– |
Patients with other diagnoses (non-CF) |
– |
|
|
Of all diagnostic categories, CF experienced the significantly highest QALY (p < 0.05). When compared to patients with interstitial lung disease, CF patients experienced significantly improved HRQoL (p < 0.05). In the SGRQ score there was an 8-unit difference and in the SF-36 PCS there was a 4-unit difference (95% CI, 2‒7). No significance difference was identified between CF and COPD or pulmonary hypertension in both the SGRQ and SF-36 scores.
HRQoL measures by recipient diagnosis without imputing missing values
SGRQ (median [IQR]) (p = 0.0006): CF -49.5 (−53.5, −45.5), COPD −49.9 (−53.3, −46.5) ILD -41.1 (−44.4, 37.9) PAH −42.6 (−48.8, −36.3), Other −49.4 (−55.9, −42.8)
SF36-PCS (median [IQR]) (p = 0.03): CF 19.6 (17.5, 21.8), COPD 18.3 (16.4, 20.1) ILD 15.4 (13.6, 17.1) PAH 18.0 (14.6, 21.3), Other 17.4 (13.9, 21)
SF36-MCS (median [IQR]) (p = 0.2): CF 9.1 (6.7, 11.5), COPD 8.4 (6.4, 10.4) ILD 5.9 (4.0, 7.8) PAH 7.7 (4.0, 11.3), Other 8.1 (4.2, 12)
EQ5D (median [IQR]) (p = 0.3): CF 0.28 (0.22, 0.33), COPD 0.30 (0.26, 0.35) ILD 0.25 (0.20, 0.30) PAH 0.22 (0.14, 0.30), Other 0.31 (0.22, 0.40)
Over the first 5-years post lung transplantation, using univariate analysis, a significant difference (p = 0.03) was identified between the predicted Quality-Adjusted Life-Year (QALY) across the diagnostic categories, mean (95% CI): CF 2.87 (2.53‒3.20), COPD 2.33 (2.03‒2.63), Interstitial lung disease 2.17 (1.90‒2.44), Pulmonary arterial hypertension 2.53 (2.02‒3.04) and other 2.31 (1.77‒2.85). Using multivariate regression, however, there was no significant correlation between diagnostic categories and QALYs after age adjustment (p = 0.68).
|
2016 |
Singer2929 Singer JP, Katz PP, Soong A, Shrestha P, Huang D, Ho J, et al. Effect of lung transplantation on health-related quality of life in the era of the lung allocation score: a US prospective cohort study. Am J Transplant 2017;17(5):1334–45.
|
Questionnaire at an outpatient study facility |
Pretransplant, 3, 6 and 6-monthly thereafter until 36-months. |
– |
Patients with other diagnoses (non-CF) |
– |
|
|
No significant difference between CF patients and other diagnostic categories (COPD, pulmonary arterial hypertension, pulmonary fibrosis) were noted before lung transplantation in all HRQoL instruments.
SF12-PCS (median [IQR]): COPD 22.0 (18.4, 28.3), Pulmonary arterial hypertension 25.3 (22.8. 31.1), CF 24.1 (14.8, 25.9), Pulmonary fibrosis 22.9 (16.1, 25.7)
SF12-MCS (median [IQR]): COPD 52.6 (47.3, 58.5), Pulmonary arterial hypertension 48.8 (28.9, 62.3), CF 44.1 (37.8, 52.6), Pulmonary fibrosis 50.9 (40.6, 57.1)
AQ20-R (median [IQR]): COPD 6 (3, 11), Pulmonary arterial hypertension 7 (2, 12), CF 5 (4, 7), Pulmonary fibrosis 7 (4, 9)
EQ5D (median [IQR]): COPD 0.69 (0.59, 0.79), Pulmonary arterial hypertension 0.79 (0.60, 0.82), CF 0.60 (0.44, 0.78), Pulmonary fibrosis 0.69 (0.55, 0.78)
A significant difference between the HRQoL (from pretransplant to 3-months posttransplant) of different diagnostic categories was identified after adjusting for age and other relevant cofactors (sex, baseline BMI, FEV1, 6-minute walk distance and Lung Allocation Score [LAS]). CF patients had the significantly greatest improvement in HRQoL across all instruments (p ≤ 0.021). Pulmonary fibrosis had similar improvements whereas pulmonary hypertension had the smallest improvements.
SF12-PCS (MCID = 5), average change (IQR): (p < 0.001) COPD 15.9 (11.5, 20.3), Pulmonary arterial hypertension 7.9 (1.0,14.7), CF23.8 (19.5, 28.1), Pulmonary fibrosis 13.8 (11.9, 15.8)
SF12-PCS (MCID = 5), average change (IQR): (p = 0.020) COPD 2.7 (−0.9, 6.4), Pulmonary arterial hypertension 0.1 (−5.6, 5.7), CF 10.3 (6.4,14.1), Pulmonary fibrosis 4.8 (3.1, 6.6)
AQ20-R (MCID = 1.75), average change (IQR): (p = 0.021) COPD 7.7 (6.4, 9.1), Pulmonary arterial hypertension 4.5 (2.1, 6.9), CF 9.4 (8.2,10.6), Pulmonary fibrosis 7.9 (7.3, 8.6)
EQ5D (MCID = 0.06), average change (IQR): (p = 0.003) COPD 0.15 (0.08, 0.21), Pulmonary arterial hypertension 0.07 (-0.05, 0.19), CF 0.30 (0.22, 0.32), Pulmonary fibrosis 0.16 (0.13, 0.19)
No significant difference was identified across all HRQoL instruments between patients who had improved HRQoL and patients who did not have improved HRQoL in CF patients, or patients without a diagnosis of CF (pulmonary fibrosis, COPD, pulmonary hypertension).
Diagnosis and quality of life (mean ± SD)
SF12-PCS (not improved frequency [% of not improved], improved frequency [% of improved]): COPD 7 (23%), 16 (15%), Pulmonary arterial hypertension 2 (7%), 3 (3%), CF 3 (10%), 11 (10%), Pulmonary fibrosis 18 (60%), 80 (73%)
SF12-MCS (not improved frequency [% of not improved], improved frequency [% of improved]): COPD 21 (23%), 2 (4%), Pulmonary arterial hypertension 4 (4%), 1 (2%), CF 8 (9%), 6 (13%), Pulmonary fibrosis 60 (65%), 38 (81%)
AQ20-R (not improved frequency [% of not improved], improved frequency [% of improved]): COPD 1 (6%), 22 (18%), Pulmonary arterial hypertension 3 (19%), 2 (2%), CF 0 (0%), 14 (11 %), Pulmonary fibrosis 12 (75%), 87 (70%)
EQ5D (not improved frequency [% of not improved], improved frequency [% of improved]): COPD 14 (23%), 9 (11%), Pulmonary arterial hypertension 5 (8%), 0 (0%), CF 3 (5%), 11 (14%), Pulmonary fibrosis 38 (63%), 61 (75%)
|
2020 |
Perez2525 Perez AA, Hays SR, Soong A, Gao Y, Greenland JR, Leard LE, et al. Improvements in frailty contribute to substantial improvements in quality of life after lung transplantation in patients with cystic fibrosis. Pediatr Pulmonol 2020;55(6):1406–13.
|
Assessments and multi-instrument HRQoL battery |
Before and at 3- and 6-months post lung transplantation |
Yes |
Patients on waiting list |
– |
|
|
Post lung transplantation, CF patients experienced improvements in HRQoL. At 6-months post lung transplantation: SF12-PCS (MCID = 5) improved by 33.0 (95% CI, 28.9, 37.1), 6.6-fold what is clinically significant, SF12-MCS (MCID = 5) improved by 7.6 (95% CI, 3.7, 11.5), 1.5-fold what is clinically significant, and AQ20-R (MCID = 1.75) improved by 12.41 (95% CI, 11.19, 13.64), 7.1-fold what is clinically significant. The range of improvement overall was from 1.5 to 7.1-fold the instrument’s clinically significant difference.
HRQoL instrument scores at baseline, 3-months post Lung transplantation, 6-months post Lung transplantation (mean ± SD)
SF12-PCS (MCID = 5): 21.0 ± 7.2, 51.1 ± 8.8, 54.5 ± 8.4
SF12-MCS (MCID = 5): 46.3 ± 7.5, 56.7 ± 8.3, 53.5 ± 9.4
AQ20-R (MCID = 1.75): 12.00 ± 1.98, 3.37 ± 2.43, 2.58 ± 2.01
EQ5D (MCID = 0.06): 0.56 ± 0.29, 0.90 ± 0.09, 0.90 ± 0.16
|
2020 |
Stacel2626 Stącel T, Jaworska I, Zawadzki F, Wajda-Pokrontka M, Tatoj Z, Urlik M, eds. Assessment of quality of life among patients after lung transplantation: a single-center study. Transplantation proceedings, Elsevier; 2020.
|
Questionnaire administered at follow-up clinic |
Pretransplant, 3-, 6- and 6-monthly thereafter until 36-months. 54.97 ± 41.28 months (range: 12-months to 145-months) |
Yes |
Patients with other diagnoses (non-CF), Normative polish population |
– |
|
|
When compared to a healthy Polish population, patients who have undergone lung transplantation have improved HRQoL in the WHOQoL-BREF domains: physical, psychological, environmental (26.75 points ± 4.97 vs. 15.79 points ± 2.23; 22.28 points ± 3.52 vs. 13.79 points ± 2.51; and 29.77 points ± 3.72 vs. 13.10 points ± 2.43, respectively).
In all domains of the WHOQoL-BREF, no statistically significant difference was identified between CF patients when compared to COPD and ILD patients.
WHOQoL-BREF scores comparing CF, COPD, and interstitial lung disease patients:
Somatic: CF 27.53 ± 4.53, COPD 26.93 ± 4.68, ILD 26.75 ± 4.28
Psychological: CF 23.20 ± 2.57, COPD 21.53 ± 3.18, ILD 22.90 ± 3.59
Social: CF 11.53 ± 2.75, COPD 11.13 ± 2.44, ILD 11.30 ± 2.97
Environment: CF 30.40 ± 2.53, COPD 28.73 ± 3.15, ILD 30.40 ± 4.19
CF patients had significantly improved SGRQ scores compared to ILD in the domains: total score (p = 0.028) and activity (p = 0.025). SGRQ scores were markedly improved in CF patients than in ILD and in COPD patients, but no statistically significant difference was identified.
SGRQ scores comparing CF, COPD and interstitial lung disease patients:
Symptoms (%): CF 23.28 ± 21.16, COPD 36.99 ± 32.47, ILD 32.36 ± 23.77
Activity (%): CF 20.28 ± 26.25, COPD 40.26 ± 30.77, ILD 39.26 ± 21.81
Impacts (%): CF 17.67 ± 16.84, COPD 28.21±18.13, ILD 28.65 ± 16.66
Total (%): CF 19.38 ± 17.51, COPD 33.07 ± 23.39, ILD 32.47 ± 16.02
Comparing WHOQoL-BREF scores to a Polish normative population (Jaracz et al.) the CF patients had improved HRQoL in the domains: somatic (27.53 ± 4.53 vs. 15.79 ± 2.23), psychological (15.79±2.23 vs. 23.20 ± 2.57) and environmental (30.40 ± 2.53 vs. 13.10 ± 2.43), but no statistically significant difference was identified.
The CF patients post lung transplantation had improved HRQoL using the SGRQ instrument when compared to a normative CF population from a Toronto Centre Study (19.4% vs. 46.0%)
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