Abstract
BackgroundThe association between disease markers and health status (HS) overtime is unclear. The aim of this study was to verify the predictors of HS at baseline and after three years in Chronic Obstructive Pulmonary Disease (COPD) patients.MethodsNinety-five consecutive COPD patients (66% male, age = 67 ± 9 y, FEV1 = 58 ± 23%) underwent the following evaluations at baseline and after three years: body composition, pulse oximetry (SpO2), six-minute walk distance (6MWD), Modified edical Research Council dyspnea scale (MMRC) and Saint George's Respiratory Questionnaire (SGRQ). The Charlson comorbidity index and BODE index were calculated. COPD exacerbations during the follow-up were evaluated. At baseline, age, gender, smoking, SpO2, BODE index or its components (BMI, MMRC, FEV1 and 6MWD), and Charlson index were included in a multiple linear regression analysis with the baseline SGRQ total score as the dependent variable. After three years, we included the final values of the variables plus the number of exacerbations and the final SGRQ total score as the dependent variable.ResultsSGRQ total score (42 ± 19% vs 44 ± 19%; p = 0.041) and activity domain (52 ± 21% vs 60 ± 22%; p < 0.001) deteriorated during follow-up. At baseline, BODE index was selected as a predictor of SGRQ total score (R2 = 0.46; p < 0.001); after three years, BODE index and age were the predictors (R2 = 0.49; p < 0.001). When the BODE index was replaced by its variables, MMRC was selected as the only variable associated with the SGRQ total score (R2 = 0.58; p < 0.001). After three years, MMRC, FEV1 and number of exacerbations were selected as predictors of SGRQ total score (R2 = 0.63; p < 0.001).ConclusionHS deteriorated significantly over the three-year period and the predictors of HS do not change over time. BODE index and dyspnea were predictors at baseline and after three years. Exacerbation was also a predictor of HS after three years.Trial RegistrationClinicalTrials.gov: NCT00605540
Highlights
Chronic obstructive pulmonary disease (COPD) has significant extrapulmonary consequences that lead to comorbidity conditions and effects on patients’ quality of life (QoL) [1]
Major inclusion criteria were clinical diagnosis of Chronic Obstructive Pulmonary Disease (COPD) according to criteria set out in Global initiative for chronic obstructive lung disease (GOLD) 2009 and the Brazilian Thoracic Society (BTS) [1,13], age ≥ 40 years, smoking history ≥ 10 pack-years, and a postbronchodilator Forced expiratory volume in 1 second (FEV1)/Forced expiratory vital capacity (FVC) ratio < 70%
Age, gender, smoking status, pulse oximetry (SpO2), BMI/airflow obstruction/dyspnea/exercise capacity (BODE) index or its components (BMI, Modified Medical Research Council (MMRC), FEV1 and six-minute walk distance (6MWD)), and Charlson index were included in a multiple linear regression analysis with the baseline Saint George’s Respiratory Questionnaire (SGRQ) total score as the dependent variable
Summary
Chronic obstructive pulmonary disease (COPD) has significant extrapulmonary consequences that lead to comorbidity conditions and effects on patients’ quality of life (QoL) [1]. Health status is an important measurable outcome in patients with COPD, since it is identified as a predictor of mortality and often worsens significantly with disease progression [4,5,6,7]. Only two studies verified associations between modifications of disease markers and HS and both did not include exacerbation rate as a predictor over time [7,11]. Exacerbations of COPD indicate progression of the disease and are associated with reduced health status [12]. The aim of this study was to verify the predictors of health status at baseline and after three years in COPD patients. The aim of this study was to verify the predictors of HS at baseline and after three years in Chronic Obstructive Pulmonary Disease (COPD) patients
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