Upper airway symptoms and quality of life in chronic obstructive pulmonary disease (COPD)

To assess the impact on quality of life from upper airway symptoms in chronic obstructive pulmonary disease (COPD).

Sixty-five patients with moderate-to-severe COPD were studied using the 20-item Sino-Nasal Outcome Test (SNOT-20) questionnaire, a validated disease-specific health-related quality of life tool for the assessment of rhinosinusitis. Patients also completed the St. George's Respiratory Questionnaire (SGRQ).

Eighty-eight percent of patients experienced nasal symptoms on most days of the week, most commonly rhinorrhoea. The mean SNOT-20 score of 1.24 demonstrates that nasal symptoms cause impairment to quality of life. The SNOT-20 score correlated with the number of chronic nasal symptoms (rho = 0.51, P < 0.01): the more daily nasal symptoms experienced, the greater the impact on health status. There was no significant correlation between SNOT-20 and SGRQ (r = 0.21, P = 0.09) suggesting that both upper and lower airway symptoms contribute to the total quality of life burden.

This is the first study to report on upper airway involvement in well characterised COPD patients using a previously validated assessment tool. Upper airway symptoms are frequent in these patients and cause impairment to the quality of life. These effects may not be detected using currently available quality of life tools that focus on lower respiratory tract symptoms.