reflection objective: To assess health-related quality of life (HRQL) in a low-income population of patients with hypoxemia and COPD receiving long-term oxygen therapy (LTOT).

Design: Cross-sectional study

Setting: Large, tertiary care, university teaching hospital.

Patients or participants: Thirty-six patients with COPD requiring LTOT (mean age, 635 years; mean FE[Vsub1] 321% of predicted; Pa[O.sub.2], 502 mm Hg) and 33 restrain subjects with COPD but no strait-laced hypoxemia (mean age, 63.1 years; FE[Vsub1] 357%; Pa[O.sub.2], 665 mm Hg)

Interventions: Patients underwent pulmonary function testing to assess physiologic function and the stage of respiratory impairment. A baseline dyspnea index (BDI) was used to determine of the same heights of dyspnea, and a 6-min walk trial was performed to evaluate physical performance and exercise capacity. The St George Respiratory Questionnaire (SGRQ) and the Medical consequences Study Short-Form 36-item questionnaire (SF-36) were used to assess health status and HRQL

Measurements and results: The scores onward the SGRQ and SF-36 indicated strict impairment. Patients receiving LTOT showed a sweep toward worse scores on most numerous dimensions of the SGRQ and SF-36 on the other hand differences between groups were sole statistically significant for the physical functioning and social functioning dimensions of the SF-36 Dyspnea, as measured by means of the BDI, significantly correlated with all questionnaire domains excepting the SF-36 pain index.

Conclusions: The HRQL of these low-income patients with COPD was markedly impaired, with more pronounced impairment in those receiving LTOT. The severity of dyspnea was a significant predictor of various component parts of quality of life in these patients.

elucidation words: COPD; long-term oxygen therapy; quality of life

Abbreviations: ADL = activities of daily living; BDI = baseline dyspnea index; HRQL = health-related quality of life; LTOT = long-term oxygen therapy. PEmax = maximum expiratory pressure; PImax = maximum inspiratory pressure; QoL = quality of life; SF-36 = Medical consequences Study Short-Form 36-item questionnaire; SGRQ = St George Respiratory Questionnaire

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Treatment of COPD is largely palliative, directed toward symptom reign over and the reduction of acute exacerbations. The impact of the disease and its treatment upon the health-related quality of life (HRQL) of these patients has been studied in novel years. Compared with the general population, patients with strait-laced COPD have significant impairment in their quality of life (QoL) (1-5) QoL is lower in patients with strict COPD, but even those with mild disease have HRQL of the same heights lower than those seen in the general population. (2) This impairment manifests not merely as a loss of physical mobility, if it be not that also as emotional and lie in the grave disturbances. (6)

Long-term oxygen therapy (LTOT) became a standard treatment for patients with COPD and morose hypoxemia, mainly due to reports of increased life expectancy in like patients. (7-9) Several studies have shown the deterioration in the QoL of patients with COPD and hypoxemia. (341011) However, scarcely any studies have addressed the impact of LTOT in succession QoL, and available results are conflicting. Okubadejo et al (12) find outed no change in the QoL of patients with COPD after 6 month of LTOT. Other investigators have reported similar accrues (13,14) Conversely, there are a certain number of reports of improved QoL after LTOT. (715)

The aim of this studious mood was to use the Portuguese (Brazil) version of the St George Respiratory Questionnaire (SGRQ) and the Medical consequences Study Short-Form 36-item questionnaire (SF-36) to evaluate HRQL in a low-income population of patients with hypoxemia and COPD receiving LTOT. These rises were compared with those from patients with a similar class of airflow limitation but les unadorned hypoxemia not requiring LTOT, who serv as a command group.

MATERIALS AND METHODS

Setting

This cogitation was conducted in a large, tertiary care, university teaching hospital in Sao Paulo, Brazil. The patients assisted at our institution belong to the least-favored section of the population. The average monthly family income of the patients receiving LTOT was approximately $350 None of the patients included in this inquiry would have been able to afford LTOT.

Patient Population

studious mood subjects included patients with COPD and censorious hypoxemia from an outpatient chest clinic at our institution, who had been receiving LTOT from cylinders for 25 [+ or -] 20 years (mean [+ or -] SD) [LTOT group] All patients in the LTOT assign places to had a diagnosis of COPD a FE[Vsub1] < 15 L and a Pa[O.sub.]2 < 55 mm Hg when stable, or a Pa[O.sub.2] < 60 mm Hg with evidence of cor pulmonale or polycythemia. Exclusion criteria were radiologic evidence of any significant abnormality not attributable to COPD an inability to understand or unbroken QoL questionnaires, and an inability to perform the 6-min walking test

Of 91 adult patients receiving LTOT, 48 patients had a diagnosis of COPD Of these, seven patients died during the recruitment period, three patients were hospitalized, and sum of two units patients were excluded from the close attention due to low adherence to the LTOT regimen (assessed by the agency of cylinder refill). The remaining 36 patients with COPD receiving LTOT were enlisted in the study (LTOT group) Their mean age was 635 [+ or -] 108 years, and 21 patients were male. Thirty-three patients (25 men) with COPD nevertheless less severe hypoxemia comprised the sway group. The mean age of the mastery subjects was 63.1 [+ or -] 92 years, and none of these patients were receiving LTOT.

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