Clinical COPD Questionnaire score (CCQ) and mortality

Abstract

IntroductionThe 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.MethodsSome 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.ResultsOver 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.ConclusionCCQ is predictive of mortality in COPD patients. As HRQL and mortality are both important clinical endpoints, CCQ could be used to target interventions.

Effects of a simple prototype respiratory muscle trainer on respiratory muscle strength, quality of life and dyspnea, and oxidative stress in COPD patients: a preliminary study

“…In addition, the CCQ proved to correlate with the St George’s Respiratory Questionnaire, generic HRQL instrument SF-36 ® ,29 and CRQ-SR 28. Interesting data from a study updated in 2012 showed that the final low CCQ score was associated with low HRQoL and high mortality risk in COPD patients 46. The CCQ from this study, with its brevity and simplicity, makes it a translatable Thai version, and was suitable for routine use in this study.…”

Development and the initial validation of a new self-administered questionnaire for an early detection of health status changes in smokers at risk for chronic obstructive pulmonary disease (MARKO questionnaire)

“…In regard to this aim, the MARKO questionnaire showed a higher sensitivity for early symptoms of future possible COPD than SGRQ or CAT, with high convergent validity correlation with these already validated COPD health status questionnaires. This high convergent validity correlation is also important because it shows specificity for respiratory disorders and could probably mean that it could be associated with already known features of CAT and SGRQ, showing association with many facets of COPD, like underlying inflammation, airway limitation, breathlessness, progression of disease, morbidity, and mortality (11-15). On the other hand, at least for the 18-item version, the results were not influenced by common comorbidities and concomitant treatment.…”

Chronic Obstructive Pulmonary Disease: Clinical Review and Update on Consensus Guidelines

“…Additionally, the self-administered Clinical COPD Questionnaire (CCQ) is available to measure clinical control in patients with COPD. 34 Another severity index available for use is the Body-Mass Index, Degree of Airflow Obstruction and Dyspnea, and Exercise Capacity (BODE) Index (Table 2), which has been found more reliable as a predictor of patient hospitalization and survival than consideration of FEV 1 measure alone. 35,36 Recognizing that worsening airflow limitation in itself is not the most reliable means of assessing disease severity, a major revision was introduced in the updated GOLD guidelines, recommending use of a novel Combined COPD Assessment tool ( Figure 2), which uses an MMRC grade $ 2 or a CAT score $ 10 as an indication of severe symptom burden.…”