COPD related fatigue (COPD-RF) as a patient centred outcome tool in COPD: Various predictors and its correlation with other outcome parameters

Abstract

Introduction: Over the years approach to COPD has changed. The focus of evaluation is shifting from physiological outcome parameters to patient centred outcomes. COPD-RF is one such patient related outcome that is of considerable importance to the patients as fatigue is the second common distressing symptom in COPD & is a major concern for the patients. Aims: We aim to identify the predictors of COPD-RF and its correlation with other outcome tools like FEV1, 6 minute walk distance(6MWD),MMRC grade, BODE index & inflammatory markers. Methodology: 50 stable COPD patients were taken in the study. MMRC grade, FEV1, 6MWD, BODE index, CRP level and sputum neutrophil% obtained. COPD-RF was assessed using 13 item (FACIT-fatigue) questionnaire. The correlation analysis was done by spearman rank correlation and ANOVA. Predictors of COPD-RF were identified by multiple linear regression. Result: The fatigue score showed significant correlation with inflammatory markers (CRP-r=-0.675; neutrophil%- r=-0.485) & 6MWD(r=-.428). Categorical variables (MMRC, FEV1 GOLD stages & BODE quartiles) also showed significant difference of fatigue among categories. BODE index & serum CRP were identified as the statistically significant predictors of fatigue, suggesting COPD-RF could be a reflection of severity of underlying pathophysiologic process ie systemic inflammation. Conclusion: BODE index and CRP levels are the two important surrogate markers that predicts COPR-RF implying a role of systemic inflammation in the pathogenesis of fatigue & COPD-RF could be an indicator of longterm prognosis of the disease & should be routinely evaluated during COPD assessment.