Assessment of dyspnea in severe exacerbation of chronic obstructive pulmonary disease using the Multidimensional Dyspnea Profile (MDP)

Abstract

<b>Background:</b> Dyspnea is a multidimensional subjective experience with distinct sensory qualities and emotional responses. It is the main symptom of chronic obstructive pulmonary disease (COPD). Respiratory symptom worsening and the need for additional therapy may lead to hospitalisation in COPD patients. Aim of this study is to assess the multidimensional sensation of dyspnea during a severe COPD exacerbation (ECOPD) and its changes during hospital stay using the Multidimensional Dyspnea Profile (MDP). <b>Methods:</b> Patients admitted to the hospital due to ECOPD were recruited. Patients were&nbsp;questioned concerning their current dyspnea and therefore received the MDP in a time window of 48 hours after admission (V1) and again before discharge (V2). Diagnosis and treatment of ECOPD were analogue to international guidelines. <b>Results:</b> 50 patients with severe ECOPD were included (46% female, age 65.8±9.3, FEV1% 34.5±14.3). Breathing discomfort (A1 Scale of the M) was 6.3±2.3 at V1 and declined to 4.3±2.1 at V2 (p&lt;0.001). Mean immediate perception domain score (ID) and mean emotional response domain score (ED) decreased from 34.9±13.6 to 25.9±13.1 (p&lt;0.001) and from 26.9±15.2 to 19.9±14.5 (p=0.001). Most frequently chosen best descriptor for current dyspnea (SQ best choice) at V1 was air hunger (34%) which was significantly less chosen at V2 (14%, p=0.004). <b>Conclusion:</b> Dyspnea and emotional responses to dyspnea decline during hospitalization in patients with severe ECOPD. Air hunger is the most frequent sensory quality descriptor at hospital admission.&nbsp;Clinical data, such as lung function tests, do not reflect dyspnea well, therefore the MDP is a valuable instrument.