Respiratory impairment impacts QOL in osteogenesis imperfecta independent of skeletal abnormalities

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ORIGINAL ARTICLE

Respiratory impairment impacts QOL in osteogenesis imperfecta independent of skeletal abnormalities Elizabeth A. Yonko 1 & Jillian S. Emanuel 1 & Erin M. Carter 1 & Robert A. Sandhaus 2 & Cathleen L. Raggio 1 Received: 30 June 2020 / Accepted: 1 September 2020 # International Osteoporosis Foundation and National Osteoporosis Foundation 2020

Abstract Summary Respiratory insufficiency is the leading cause death in people with osteogenesis imperfecta (OI). Adults with OI reported that respiratory symptoms negatively impacted psychosocial wellbeing and limited daily physical activities, irrespective of OI type, age, stature, or scoliosis. The impact of respiratory status on quality of life in this population warrants further investigation. Purpose Respiratory insufficiency is the leading cause of mortality in osteogenesis imperfecta (OI), a heterogeneous group of heritable connective tissue disorders characterized by fractures, bone fragility, and scoliosis. There is little research on how respiratory health influences daily life in this population. This study explores the relationship between respiratory function and quality of life in adults with OI. Methods One hundred fifty-seven adults with OI completed the St. George’s Respiratory Questionnaire (SGRQ) and provided demographic and health information through REDCap. SGRQ scores were compared to reference scores for the general population, and comparisons were made between OI type, presence of scoliosis, stature, and other factors such as age or comorbidities. Results Average age was 45.87 years (range 19–81). Respondents scored worse on average (32 ± 23) than the normative data (6 ± 1). Those with type I OI scored better than those with type IV (p = 0.002) or type III (p = 0.024). Total scores correlated with age, activity level, assistive device use, and presence of pulmonary or cardiac comorbidities but did not correlate with stature or degree of scoliosis. Conclusion Respiratory symptoms negatively impact both psychosocial wellbeing in the OI population and limit daily physical activity. These limitations occur irrespective of their OI type, age, stature, or scoliosis and reflect the dramatic impact of respiratory status on quality of life for people with OI. Future studies should examine the etiology of respiratory insufficiency in this population so guidelines for management can be established. Keywords Osteogenesis imperfecta . St George’s Respiratory Questionnaire . Respiratory health . Quality of life . Pulmonary . Cardiac

Introduction Osteogenesis imperfecta (OI) is a group of heritable connective tissue disorders estimated to occur in 1 in 15,000 live births [1]. OI is characterized by bone fragility, fractures, short

* Robert A. Sandhaus [email protected] 1

Kathryn O. and Alan C. Greenberg Center for Skeletal Dysplasias, Hospital for Special Surgery, New York, NY, USA

2

Division of Pulmonary, Critical Care, and Sleep Medicine, National Jewish Health, 1400 Jackson Street, Denver, CO 80206, USA

stature, and scoliosis. Although