Quality of life in newly di̇agnosed pati̇ents wi̇th idiopatic pulmonary fibrosis

Objective: This study was performed to evaluate the effect of dyspnea, cough, sleep disturbance, anxiety, depression and physiological parameters on quality of life in patients who were diagnosed with IPF for the first time and never received treatment. Method: Forty patients with idiopathic pulmonary fibrosis (IPF) were enrolled. The diagnosis of IPF was established based on the American Thoracic Society (ATS)/European Respiratory Society (ERS)/Japanese Respiratory Society (JRS)/The Latin America Thoracic Association (ALAT) statement. All patients included in the study had newly diagnosed IPF. We analyzed consecutive subjects with IPF who completed a systematic evaluation including pulmonary function tests, PaO2 at rest, 6-minute walk test (6MWT), GAP index. HRQL was assessed by the SF36 questionnaire and the St. George's Respiratory Questionnaire (SGRQ). Dyspnea was measured by BORG scale and Modified Medical Research Council Scale (MRC), sleep quality was assessed by Pittsburgh sleep quality index (PSQI), depression and anxiety was measured by Hospital Anxiety and Depression Scale (HADS), In addition, Leicester Cough Questionnaire (LCQ) was used. We designed this study to identify independent determinants of the St. George's Respiratory Questionnaire (SGRQ) score and SF36 score among various factors. Results: A total of 40 IPF cases, 6 (15%) female and 34 (85%) male, were included in this study. The mean age of the patients was 67 ± 9 years and the mean weight was 77 ± 13 kg. MMRC dyspnea scale score, BORG scale score, Anxiety (HADS-A) and PUKİ score were significantly correlated with the SGRQ total score. No significant correlation was found between FVC (functional vital capacity)% predicted, DLCO (carbon monoxide diffusion capacity) adj % predicted values, 6MWT distance a, GAP index and St. George' s Respiratory Questionnaire (SGRQ) total score. Patients scored significantly bad with respect to the SF-36 domains of physical functioning, physical role, general health perceptions, vitality, social functioning, emotional role, and mental health index. MMRC scores were significantly correlated with seven SF-36 components, and PUKİ significantly correlated with four SF-36 components. Significant negative correlations were found between the HADS and SF-36 domains. Symptoms of depression and anxiety were present in 27.5% and 17.5% of patients with IPF, respectively. Mean HAD-A score was 7±4 and mean HAD-D score was 7±4. FVC (functional vital capacity)% predicted, DLCO (carbon monoxide diffusion capacity) adj% predicted values, 6MWT distance and GAP index were not significantly correlated with depression and anxiety. PUKI score was 4 [3-7,5]. It was determined that 40% of the patients participating in the study had poor sleep quality. Poor sleep quality was not associated with body mass index, age, gender. In multivariate multiple regression analysis, MMRC dyspnea scale, the HADS anxiety, PUKI total score was selected as the factor significantly contributing to the total SGRQ score. Conclusions: In this study, we showed that the most important factors that determine the quality of life in IPF patients are dyspnea, sleep quality and anxiety. To improve the quality of life in these patients, we should increase the awareness of symptoms, especially anxiety, sleep quality, shortness of breath, and evaluating treatment options for palliation of symptoms, thats will improve patients' quality of life. There is a need for multicentre studies involving more patients on this subject