Association of Ventilatory Disorders with Respiratory Symptoms, Physical Activity, and Quality of Life in Subjects with Prior Tuberculosis: A National Database Study in Korea

Abstract

Tuberculosis (TB) survivors experience post-TB lung damage and ventilatory function disorders. However, the proportions of obstructive and restrictive ventilatory disorders as well as normal ventilation among subjects with prior TB are unknown. In addition, the impacts of ventilatory disorder and its severity on respiratory symptoms, physical activity limitations, and the quality of life in subjects with prior TB remain unclear. Subjects who participated in the Korean National Health and Nutritional Examination Survey 2007–2016 were enrolled in this study. We evaluated the impact of each ventilatory disorder and its severity on respiratory symptoms, physical activity limitations, and quality of life (measured by the EuroQoL five dimensions questionnaire [EQ-5D] index values) in subjects with prior TB. Among 1466 subjects with prior TB, 29% and 16% had obstructive ventilatory disorders and restrictive ventilatory disorders, respectively. Mild and moderate obstructive ventilatory disorders were not associated with respiratory symptoms, physical activity limitations, or EQ-5D index value compared with normal ventilation; however, severe obstructive ventilatory disorders were associated with more respiratory symptoms (adjusted odds ratio [aOR] = 13.62, 95% confidence interval [CI] = 4.64–39.99), more physical activity limitation (aOR = 218.58, 95% CI = 26.82–1781.12), and decreased EQ-5D index (adjusted coefficient = −0.06, 95% CI = (−0.12–−0.10) compared with normal ventilation. Mild restrictive ventilatory disorders were associated with more respiratory symptoms (aOR = 2.10, 95% CI = 1.07–4.14) compared with normal ventilation, while moderate (aOR = 5.71, 95% CI = 1.14–28.62) and severe restrictive ventilatory disorders (aOR = 9.17, 95% CI = 1.02–82.22) were associated with physical activity limitation compared with normal ventilation. In conclusion, among subjects with prior TB, 29% and 16% developed obstructive and restrictive ventilatory disorders, respectively. Severe obstructive ventilatory disorder was associated with more respiratory symptoms, more physical activity limitation, and poorer quality of life, while severe restrictive ventilatory disorder was associated with more physical activity limitations.

Impaired pulmonary function and associated factors in the elderly with tuberculosis on admission

“…For example, Lee et al have found that the FVC and postbronchodilator FEV1 of patients with chronic air ow obstruction were less than those of COPD patients (P < 0.05) [23]. Furthermore, Yang et al have determined that severe obstructive ventilatory disorders are associated with more respiratory symptoms, and among subjects with prior TB, 29% developed obstructive ventilatory disorders [24]. Abnormal lung function associated with pulmonary TB was observed in 18-94% of patients.…”

Respiratory and Critical Care

“…chest radiography and computed tomography, -spirometry (including bronchodilator response), -plethysmography (assessment of lung volumes), -DLCO (diffusion for carbon oxide), -arterial blood gas analyses (median arterial blood oxygen saturation and mean arterial oxygen partial pressure), -evaluation of the capacity to perform exercise via the six minute walk test (6MWT) or the incremental shuttle walk test (ISWT) [4,31,149,150,[152][153][154][155].…”

“…In other words, management of possible fungal infections in those individuals could lead to higher rates of candidate identification for future pulmonary rehabilitation programs. Moreover, fibrotic patterns, revealed by chest X-rays, can lead to pain or dyspnea (specific symptoms of restrictive ventilatory pathogenesis) [154,158], further selecting post-TB survivors as possible rehabilitation recipients.…”

“…Several studies reported improvement in patients diagnosed with post-TB pathology after 6MWT and ISWT after measuring forced expiratory volume (FEV 1 ), forced vital capacity (FVC), median arterial blood oxygen saturation (SaO 2 ), and mean arterial oxygen partial pressure (PaO 2 ) [3,27,152]. Lower FEV 1 /FVC ratios are correlated with chronic post-TB airflow obstruction [149,154,160], while lower a FVC result predicts restrictive symptoms [154,158,164]. Approximately 60% of participants from the study conducted by Jones et al diagnosed with post-TB pathogenesis recorded improvement in the sit-to-stand test and in ISWT, as well as a reduction of restrictive ventilatory symptoms (hemoptysis and pain) [27].…”

Secular trends and determinants of influenza vaccination uptake among patients with cardiovascular disease in Korea: Analysis using a nationwide database

“…Data on age, sex, body mass index (BMI), smoking history, alcohol consumption, marital status, income, area of residence, education, and cardiac symptoms were obtained from the NHANES database. Comorbidities of stroke, asthma, pulmonary tuberculosis, and chronic kidney disease were self-reported based on previous physician diagnoses (10)(11)(12)(13). Chronic obstructive pulmonary disease (COPD) was defined based on pre-bronchodilator forced expiratory volume in 1 s (FEV 1 )/forced vital capacity (FVC) < 0.7 (14).…”