Synergistic destruction of pulmonary tissue
Effective monitoring of health-status deterioration is crucial in CPA, since failure to proactively manage early deterioration may result in further lung damage and development of complications such as hemoptysis, which may otherwise have been preventable or amenable to treatment in Australian Viagra Pharmacy. Moreover, this association between CPA severity and SGRQ scores suggests that the SGRQ could serve in assessing health status in clinical trials, measuring response of CPA to medical or surgical intervention from the patient’s perspective. In other chronic respiratory diseases, such as COPD, it has been documented that a four-point change in SGRQ scores represents the minimum clinically significant difference. However, future studies are needed to determine the equivalent value in CPA.
SGRQ scores showed only modest correlation with impairment in lung function, which accords with previous studies in other chronic progressive pulmonary diseases, such as COPD and bronchiectasis. As with patients with bronchiecatasis and pulmonary TB, SGRQ scores in this cohort were not affected by sex difference, supporting the stability of SGRQ in assessing health status in CPA.
This study showed that COPD was the most common and effective underlying comorbidity with CPA. Since both CPA and COPD are chronic, progressive, inflammatory, pulmonary diseases, a possibility of an existing interaction between these two diseases can be suggested. Perhaps “synergistic” destruction of pulmonary tissue and inflammation would contribute to the high SGRQ score of those who had both diseases. Further investigation of the management of such cases may be warranted. This finding should be further investigated in a longitudinal cohort study. Moreover, another interesting observation was that the SGRQ total score maintained its association with CPA severity even after being adjusted to several possible cofounders, including COPD and other underlying chronic pulmonary diseases. This shows that health-status impairment in CPA is independently related to CPA severity, but can be exaggerated by the presence of other coexisting pulmonary diseases.
We found no statistically significant association between socioeconomic status and SQRQ total and dimensional scores. This is consistent with findings in other chronic progressive pulmonary diseases in which socioeconomic factors did not correlate with SGRQ score, as shown by Stahl and colleagues.
