Clinical COPD Questionnaire score (CCQ) and mortality

ical COPD Questionnaire score (CCQ) and mortality Original Research (1470) Total Article Views Authors: Sundh J, Janson C, Lisspers K, Montgomery S, St llberg B Published Date December 2012 Volume 2012:7 Pages 833 - 842 DOI: http://dx.doi.org/10.2147/COPD.S38119 Received: 14 September 2012 Accepted: 28 October 2012 Published: 20 December 2012 Josefin Sundh,1 Christer Janson,2 Karin Lisspers,3 Scott Montgomery,4–6 Bj rn St llberg3 1Department of Respiratory Medicine, rebro University Hospital, rebro, Sweden; 2Department of Medical Sciences, Respiratory Medicine and Allergology, Uppsala University, Uppsala, Sweden; 3Department of Public Health and Caring Science, Family Medicine and Clinical Epidemiology, Uppsala University, Uppsala, Sweden; 4Clinical Epidemiology and Biostatistics Unit, rebro University Hospital, rebro, Sweden; 5Clinical Epidemiology Unit, Karolinska University Hospital, Stockholm, Sweden; 6Department of Primary Care and Public Health, Charing Cross Hospital, London, United Kingdom Introduction: The Clinical COPD Questionnaire (CCQ) measures health status and can be used to assess health-related quality of life (HRQL). We investigated whether CCQ is also associated with mortality. Methods: Some 1111 Swedish primary and secondary care chronic obstructive pulmonary disease (COPD) patients were randomly selected. Information from questionnaires and medical record review were obtained in 970 patients. The Swedish Board of Health and Welfare provided mortality data. Cox regression estimated survival, with adjustment for age, sex, heart disease, and lung function (for a subset with spirometry data, n = 530). Age and sex-standardized mortality ratios were calculated. Results: Over 5 years, 220 patients (22.7%) died. Mortality risk was higher for mean CCQ ≥ 3 (37.8% died) compared with mean CCQ < 1 (11.4%), producing an adjusted hazard ratio (HR) (and 95% confidence interval [CI]) of 3.13 (1.98 to 4.95). After further adjustment for 1 second forced expiratory volume (expressed as percent of the European Community for Steel and Coal reference values ), the association remained (HR 2.94 [1.42 to 6.10]). The mortality risk was higher than in the general population, with standardized mortality ratio (and 95% CI) of 1.87 (1.18 to 2.80) with CCQ < 1, increasing to 6.05 (4.94 to 7.44) with CCQ ≥ 3. Conclusion: CCQ is predictive of mortality in COPD patients. As HRQL and mortality are both important clinical endpoints, CCQ could be used to target interventions.