Health-related quality of life in patients with bronchiolitis obliterans
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Published on: August 24, 2019
Emine Atag1, Nilay Bas Ikizoglu2, Pinar Ergenekon2
1Division of Pediatric Pulmonology, Faculty of Medicine, Medipol University, Istanbul, Turkey.
Insights
Children with bronchiolitis obliterans (BO) have lower health-related quality of life (HRQOL) than healthy peers. Post-hematopoietic stem cell transplantation (HSCT) BO significantly impacts HRQOL more than post-infectious causes.
Area of Science:
- Pediatric Pulmonology
- Quality of Life Research
- Chronic Lung Diseases
Background:
- Bronchiolitis obliterans (BO) is a severe obstructive lung disease.
- BO in children commonly results from infections or hematopoietic stem cell transplantation (HSCT).
- Understanding the impact of BO on children's quality of life is crucial for management.
Purpose of the Study:
- To compare the health-related quality of life (HRQOL) of children with BO to that of healthy children.
- To investigate how the etiology of BO (post-infectious vs. post-HSCT) affects HRQOL.
Main Methods:
- A cohort of children with BO (post-infectious and post-HSCT) and healthy controls were assessed.
- Health-related quality of life was measured using the Short Form-36 (SF-36) and St George's Respiratory Questionnaire (SGRQ).
- Correlations between clinical factors, pulmonary function, imaging, and HRQOL were analyzed.
Main Results:
- Children with BO demonstrated significantly lower SF-36 scores compared to healthy children.
- Post-HSCT BO patients exhibited poorer HRQOL in physical and social functioning compared to post-infectious BO.
- Poorer lung function and increased healthcare utilization (therapies, exacerbations, hospitalizations) correlated with lower HRQOL.
Conclusions:
- Children with BO experience a diminished HRQOL, particularly those following HSCT.
- HRQOL assessment is essential for comprehensive care and management strategies in pediatric chronic lung diseases like BO.
Introduction:
Bronchiolitis obliterans (BO) is mainly caused by infections and hematopoietic stem cell transplantation (HSCT). This study aimed to investigate the health-related quality of life (HRQOL) of children with BO compared to the healthy children and also to assess the HRQOL according to the etiology.
Methods:
Postinfectious (group 1) and post-HSCT BO (group 2) patients and healthy children were included in the study. HRQOL was assessed by the Short Form-36 (SF-36) and St George's Respiratory Questionnaire (SGRQ). Correlations between demographic and clinical characteristics, pulmonary function tests, high-resolution chest tomography scores, and HRQOL were assessed.
Results:
Thirty-seven postinfectious and post-HSCT BO patients and 34 healthy children were included in the study. Mean age was 13.8 ± 0.7 years. Mean forced vital capacity and forced expiratory volume1 were 60.7 ± 2.7% predicted, and 49.8 ± 3.1% predicted, respectively. The SF-36 scores were lower in BO patients compared to healthy children (P < .01). Patients with better lung functions had higher SF-36 scores, but lower SGRQ. The number of inhaled therapies, acute exacerbations, hospitalizations were inversely correlated with SF-36. A positive correlation was found between these parameters and total SGRQ scores (r = .507, P = .02; r = .409, P = .12; r = .326, P = .049, respectively). SF-36 scores were better in group 1 for subscales of physical role functioning and social role functioning compared to group 2. (P = .01, P = .01, respectively).
Conclusion:
The HRQOL of patients with BO measured by SF-36 was low compared to healthy children. SF-36 scores were more affected in post-HSCT BO patients. HRQOL of children with chronic lung disease should be taken into consideration in the management of these patients.
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