Author(s)
Hajira Wehelie MPH
Ryan Stepp BS
Andrew Mathias BS
Willow Kwak BS
James Daniero MD
Affiliation(s)
University of Virginia, Charlottesville, VA, USA;
Abstract:
Background:
Subjective scales and objective assessments like pulmonary function tests (PFTs) are used to assess dyspnea in patients with subglottic stenosis. However, there is limited research on factors that contribute to discrepancies between PFTs and patient perceptions in subglottic stenosis (SGS) patients. This study aimed to explore how comorbidities influence patient perception of obstruction.
Methods:
Ninety-two patients were included. Baseline demographic data, including comorbidities, were collected and compared across SGS etiology subgroups. Additionally, Clinical COPD Questionnaire (CCQ) and Expiratory Disproportion Index (EDI) score were recorded at each appointment (N=489). A mixed-effects model was employed to account for those repeated measurements across appointments for each patient, examining the influence of demographic characteristics and clinical comorbidities on Obstruction Perception Index (OPI) score, calculated as a difference between normalized CCQ and EDI scores.
Results:
Higher BMI was significantly associated with increased OPI (Estimate = 0.0096, p < 0.001), indicating hyper-perception relative to objective findings. Idiopathic SGS was also associated with a higher OPI (Estimate = 0.12, p = 0.03). Psychiatric comorbidities were associated with increased OPI, though these findings were not statistically significant. Greater time since diagnosis (Estimate = -0.21, p = 0.27) and history of smoking (Estimate = -0.039, p = 0.60) showed a trend towards lower OPI (hypo-perception).
Conclusion:
This research provides insights into the nature of dyspnea perception in patients with subglottic stenosis. It highlights the key clinical and sociodemographic factors that influence this perception, helping healthcare providers tailor interventions to improve patient outcomes and management of this condition.