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The SAFE (SGRQ score, air-flow limitation and exercise tolerance) Index: a new composite score for the stratification of severity in chronic obstructive pulmonary disease
  1. Mohd Shah Azarisman1,
  2. Mohd Anshar Fauzi2,
  3. Mohd Perdaus Ahmad Faizal3,
  4. Zaharim Azami4,
  5. Abdul Manap Roslina5,
  6. Harun Roslan6
  1. 1Department of Medicine, International Islamic University Malaysia
  2. 2Department of Medicine, Universiti Kebangsaan Malaysia
  3. 3Department of Medicine, Universiti Kebangsaan Malaysia
  4. 4Universiti Kebangsaan Malaysia
  5. 5Department of Medicine, Universiti Kebangsaan Malaysia
  6. 6Department of Medicine, Universiti Kebangsaan Malaysia
  1. Correspondence to:
 Assistant Professor Dr Mohd Shah Azarisman
 Department of Medicine, International Islamic University Malaysia, Jalan Hospital Campus, 25150 Kuantan, Pahang, Malaysia; risman1973{at}hotmail.com

Abstract

Background: This study was proposed to develop a composite of outcome measures using forced expiratory volume percentage of predicted, exercise capacity and quality of life scores for assessment of chronic obstructive pulmonary disease (COPD) severity.

Materials and methods: Eighty-six patients with COPD were enrolled into a prospective, observational study at the respiratory outpatient clinic, National University Hospital Malaysia (Hospital Universiti Kebangsaan Malaysia - HUKM), Kuala Lumpur.

Results: Our study found modest correlation between the forced expiratory volume in 1 s (FEV1), 6 min walk distance and the SGRQ scores with mean (SD) values of 0.97 (0.56) litres/s, 322 (87) m and 43.7 (23.6)%, respectively. K-Means cluster analysis identified four distinct clusters which reached statistical significance which was refined to develop a new cumulative staging system. The SAFE Index score correlated with the number of exacerbations in 2 years (r = 0.497, p<0.001).

Conclusion: We have developed the SGRQ, Air-Flow limitation and Exercise tolerance Index (SAFE Index) for the stratification of severity in COPD. This index incorporates the SGRQ score, the FEV1 % predicted and the 6 min walk distance. The SAFE Index is moderately correlated with the number of disease exacerbations.

  • ANOVA, analysis of variance
  • COPD, chronic obstructive pulmonary disease
  • FEV1, forced expiratory volume in 1 s
  • FEV1%Pred, percentage of predicted FEV1
  • FVC, forced vital capacity
  • GOLD, Global Initiative for Chronic Obstructive Lung Disease
  • HRQOL, Health-Related Quality of Life Questionnaire
  • QOL, quality of life
  • SGRQ, St George’s Respiratory Questionnaire

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Footnotes

  • Funding was provided by the Fundamental Research Fund, National, University Malaysia – UKM.

  • Conflict of interest: none stated

  • The abstract was accepted for a poster presentation at the 11th Congress of the Asian Pacific Society of Respirology (APSR) held in Kyoto, Japan, 19–22 November 2006

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