BODE Index Score Research Articles

The effect of pulmonary rehabilitation on cardiovascular risk, oxidative stress and systemic inflammation in patients with COPD

PurposeChronic obstructive pulmonary disease (COPD) is a leading cause of death, and cardiovascular (CV) comorbidities play a role. Evidence of the pulmonary rehabilitation (PR) effect in reducing the CV risk (CVR) in COPD patients is limited. In this study, we aimed to determine the impact of an 8-week PR program (PRP) on the CVR of the overall population and to compare the impact on the exacerbator versus non-exacerbator patients. Patients and methodsThis was a prospective study that included adults who had post-bronchodilator forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC) (FEV1/FVC) ratio <70 % and FEV1 <80 % predicted, had quit smoking for at least 1 year and had a history of tobacco consumption greater than 10 packs/year, and were clinically stable in the last 8 weeks. Pre- and post-PRP assessments included respiratory function evaluation, laboratory tests, and exercise capacity assessment (6-min walking test [6MWT]). CVR was assessed using different risk prediction models. ResultsA total of 50 patients (28 exacerbators and 22 non-exacerbators) completed the PRP (median age: 64.5 years, men: 72 %; arterial hypertension: 70 %, dyslipidemia: 30 %, diabetes: 20 %; CV disease (CVD): 24 %. After the PRP, exacerbator patients showed a significant decrease in the CVR calculated by the COPDCoRi model (p < 0.001); patients with ≥30-m increase on the 6MWT showed statistically significant lower levels of glucose (p = 0.004), HbA1c (p = 0.004) and BODE index score (p = 0.026) compared to patients with <30-m increase. ConclusionsPR reduced certain modifiable CVR factors and CVD risk, especially in exacerbator patients.

Kronik Obstrüktif Akciğer Hastalığı (KOAH) Tanılı Hastaların Fonksiyonel Durumları ile D Tipi kişilik ve Psikiyatrik Belirtileri Arasındaki İlişki

Emotional difficulties, adjustment difficulties, anxiety disorder, paranoid reactions and depression are among the common psychiatric disorders in patients with Chronic Obstructive Pulmonary Disease (COPD). Type D personality is characterized by social inhibition and negative affectivity. Individuals with Type D personality have difficulty in coping with chronic diseases. The aim of our study was to determine type D personality and psychiatric symptoms in patients with COPD. A patient group was formed with 44 people hospitalized with COPD in the Chest Diseases service and a control group was formed with 44 healthy people. A sociodemographic data form, the Beck Depression Inventory, State and Trait Anxiety Inventory, Somatosensory Amplification Scale, Type D Personality Scale, and BODE (Body mass index, Obstruction, Dyspnea, Exercise capacity) index, were used to. According to the results of our study, state and trait anxiety, depression and D-type personality, exaggeration of bodily sensations scale scores were statistically significantly higher in the patient group compared to the control group. Moreover, a high score on the somatosensory amplification scale and having a type D personality were correlated with the BODE index score. These results suggest that it is important for patients with COPD to be examined by a psychiatrist..

The Association Between Comorbidities and a High-Risk Status According to COPD GOLD Groups

Objective: The natural course of the chronic obstructive pulmonary disease (COPD) is thought to be affected by the severity of COPD, frequency of episodes, as well as the presence of comorbid conditions. It was aimed to explore the effect of comorbid conditions on high-risk status in stable COPD patients. Material and methods: Study participants consisted of stable COPD patients attending to the pulmonology outpatient unit of a tertiary center between 15th May 2018 and 12th Dec 2019. Demographic data, comorbidities, clinical index scores, modified Charlson comorbidity index score (mCCI), BODE index score, and the Short Form 36 (SF-36) scores as a generic life quality measure were recorded. Global Initiative for Chronic Obstructive Lung Disease (GOLD) groups were determined based on symptoms and exacerbations. Results: There were 23(25.8%), 31(34.8%), 2(2.2%), and 33(37.1%) patients in GOLD gropus A, B, C, and D, respectively. Among these, A and B groups are considered as low-risk, and C and D groups are considered as high-risk. High risk patients had higher mCCI (p &lt; 0.001) and were more likely to have hypertension (p=0.012), congestive cardiac failure (p=0.029), chronic renal failure (p=0.022), osteoporosis (p=0.001), and anemia (p&lt;0.001). In a logistic regression analysis performed to examine the determinants of high-risk status in COPD-GOLD groups, biomass exposure was found to increase the likelihood of having a high risk-status by 3-fold. Conclusion: Classification of stable COPD patients according to GOLD groups showed higher mCCI in subjects with high-risk status. Comorbidities and mCCI did not appear to affect the high-risk status. Biomass exposure was associated with an increased risk of having a high-risk status.

Effectiveness of breathing exercises in patients with chronic obstructive pulmonary disease

Introduction: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality. Aim: The present study was undertaken to assess the effectiveness of breathing exercises in the reduction of dyspnoea among the COPD patients. Methods: A quantitative research approach, quasi experimental pre-test and post-test control group design was used in the study. The study was theoretically supported by the frame work based on goal attainment theory of Imogen King. The study was conducted in pulmonology wards of a teaching institute in South India. A total of 60 subjects were selected. The samples were selected by using convenient sampling technique. BODE index was used to grade dyspnoea. The data collected were analysed using descriptive and inferential statistics. Results: 63% of patients were having BODE index score between 4 and 7. In the experimental group the mean pre-test value was 6.13 and the mean post-test value was 2.96 and significant at p value 0.001 level. The post interventional level of dyspnoea of both groups was analysed by using Mann Whitney test, and showed a p value of 0.001. There is significant reduction in the level of dyspnoea after practising breathing exercises compared with control group. Conclusion: There is significant reduction in the level of dyspnoea among COPD patients with breathing exercises.

The Relationship of Partial Pressure of Carbon Dioxide (PaCO2) with Disease Severity Indicators Such as BODE and GOLD in Hospitalized COPD Patients.

Purpose This study aimed to investigate the relationship of partial pressure of carbon dioxide (PaCO2) with BODE and GOLD in stable COPD subjects and to explore the predictive value of PaCO2 for severe COPD (BODE index score ≥5 or GOLD index score ≥3). Patients and Methods. In total, 80 participants with COPD and free from other conditions affecting PaCO2 were recruited. Arterial blood gases, BODE, GOLD, SGRQ, lung function, and other data were collected. The BODE index was calculated, and patients were divided into two groups according to the BODE index and PaCO2 median, respectively. We used Pearson's correlation test and the receiver operating characteristic curves to evaluate the utility of PaCO2. Besides, the univariate and multivariate logistic regression analyses were conducted to verify whether PaCO2 was an independent factor associated with BODE grades. Results COPD subjects with BODE ≥5 and GOLD ≥3 had significantly higher levels of PaCO2 (p = 0.004, p = 0.001, respectively). In the high PaCO2 group, patients underwent poorer outcomes than the low PaCO2 group. PaCO2 was negatively correlated with forced expiratory volume in 1 second in percent of the predicted value (FEV1%) (r = −0.612, p < 0.001). The performance of PaCO2 levels in predicting BODE ≥5 and GOLD ≥3 was 0.748 and 0.755, respectively. The logistic regression analyses proved that PaCO2 was associated with BODE ≥5 in COPD patients (odds ratio = 1.160, 95% CI: 1.025–1.313, p = 0.019). Conclusions A higher level of PaCO2 was associated with a higher index for BODE or GOLD in COPD and had the predictive value for severe COPD.

Effects of pulmonary rehabilitation therapy combined with conventional drugs on BODE and pulmonary function indexes in elderly patients with interstitial pneumonia

Objectives:To investigate the effect of pulmonary rehabilitation therapy combined with conventional drugs on BODE and pulmonary function (PFT) indexes in elderly patients with interstitial pneumonia.Methods:Records of 89 elderly patients with interstitial pneumonia treated in the First Affiliated Hospital of Hunan Medical College from April 2020 to April 2021 were retrospectively selected. Of them, 41 patients received conventional drug treatment (Group-I) and 48 patients received pulmonary rehabilitation treatment and conventional drug treatment (Group-II). The clinical efficacy of therapy, BODE and PFT indexes of the two groups were compared.Results:The total efficacy of patients in the Group-II (93.75%) was significantly higher than that of Group-I (75.61%) (P<0.05). After the treatment, the BODE index score of Group-II was lower than that of Group-I, and the forced vital capacity (FVC), forced expiratory volume in the first second (FEV1) and peak expiratory flow rate (PEF) were higher than those of Group-I (P<0.001).Conclusion:Combination of pulmonary rehabilitation therapy and conventional drugs can further improve the curative effect of the treatment and help to improve BODE and PFT indexes in patients with senile interstitial pneumonia.

Clinical impact of forced vital capacity on exercise performance in patients with chronic obstructive pulmonary disease

BackgroundForced vital capacity (FVC) has been suggested to be a good biomarker for decreased exercise performance in patients with chronic obstructive pulmonary disease (COPD). However, as FVC is highly correlated with forced expiratory volume in 1 second (FEV1), the relationship between FVC and exercise capacity should be assessed within the category of FEV1, i.e., COPD severity. However, this was not considered in previous studies. Thus, limited data are available on the association between reduced FVC and exercise capacity measured by 6-min walk distance (6MWD) based on COPD severity.MethodsWe performed a cross-sectional study using data from the Korean COPD Subgroup Study (KOCOSS) cohort. We evaluated 1,386 patients with moderate (n=895) and severe-to-very severe (n=491) COPD. Reduced FVC was defined as FVC <80% predicted and short 6MWD as <350 m. Multivariable logistic regression was used to evaluate the association between reduced FVC and short 6MWD.ResultsThere were no significant differences in respiratory symptoms and quality of life between the patients with reduced FVC and those with preserved FVC. However, patients with reduced FVC had shorter 6MWD (30.5 cm in moderate and 34.5 cm in severe-to-very severe COPD) and higher BODE index scores than those with preserved FVC. The cubic spline model revealed 6MWD peaked around 93% predicted of FVC in moderate COPD, whereas FVC showed a positive association with 6MWD in severe-to-very severe COPD. Multivariable analyses showed that reduced FVC was significantly associated with short 6MWD in both moderate [adjusted odds ratio (aOR) =1.44, 95% confidence interval (CI): 1.03–2.02] and severe-to-very severe (adjusted OR =1.55, 95% CI: 1.01–2.40) COPD.ConclusionsReduced FVC was significantly associated with shorter 6MWD in moderate-to-very severe COPD patients, suggesting that reduced FVC might be reflective of 6MWD-measured exercise capacity in moderate-to-very severe COPD.

Sex differences between women and men with COPD: A new analysis of the 3CIA study

BackgroundThere is partial evidence that COPD is expressed differently in women than in men, namely on symptoms, pulmonary function, exacerbations, comorbidities or prognosis. There is a need to improve the characterization of COPD in females. MethodsWe obtained and pooled data of 17 139 patients from 22 COPD cohorts and analysed the clinical differences by sex, establishing the relationship between these characteristics in women and the prognosis and severity of the disease. Comparisons were established with standard statistics and survival analysis, including crude and multivariate Cox-regression analysis. ResultsOverall, 5355 (31.2%) women were compared with men with COPD. Women were younger, had lower pack-years, greater FEV1%, lower BMI and a greater number of exacerbations (all p < 0.05). On symptoms, women reported more dyspnea, equal cough but less expectoration (p < 0.001). There were no differences in the BODE index score in women (2.4) versus men (2.4) (p = 0.5), but the distribution of all BODE components was highly variable by sex within different thresholds of BODE. On prognosis, 5-year survival was higher in COPD females (86.9%) than in males (76.3%), p < 0.001, in all patients and within each of the specific comorbidities that we assessed. The crude and adjusted RR and 95% C.I. for death in males was 1.82 (1.69–1.96) and 1.73 (1.50–2.00), respectively. ConclusionsCOPD in women has some characteristic traits expressed differently than compared to men, mainly with more dyspnea and COPD exacerbations and less phlegm, among others, although long-term survival appears better in female COPD patients.

Evaluating Clinical Efficacy of Ayurvedic Inhalation Therapy (Aerosol) and Rasayan Therapy in the Management of COPD - A Randomized Cohort Control Clinical Study

Background: Chronic obstructive pulmonary disease (COPD) is a common disease characterized by dyspnea and cough with sputum, main fulminating cause for this disease is smoking (active or passive). COPD is one of the progressive disease of respiratory system and so far there is no permanent cure for this.The present study aimed to evaluate the efficacy of Ayurvedic inhalation therapy(aerosol) and Rasayana therapy (rejuvenation therapy) in the management of COPD. Method: A cohort controlled clinical study was done on 60 known cases of COPD divided into two groups equally through randomization(done by quickcalcs software). Subjects allocated in group A were given Herbal aerosol through nebulization in a dose of 2.5 ml B.I.D for 15 days followed by Rasayana therapy (Rejuvenation therapy) for one month and in Group B standard conventional therapy was given for the same duration. Primary endpoint was change in Pulmonary function test (PFT)/Spirometry. Secondary endpoint includes change inmMRC (Modified medical research council) scale, CAT(COPD assessment test) scale, SF-36 questionnaire, BODE index. Findings: There was p<0.001 found in pulmonary function test (FEV1, FVC, PEFR) in trial group and p<0.05 in control group. p<0.001 found in mMRC scale in trial group and p<0.05 in control group.p<0.05 found in SF36 questionnaire in both groups.p<0.001 found in BODE index score in trial group and p<0.05 in control group. Improvement remain constant during regular follow ups. Interpretation: This study has been done with an objective to evaluate the efficacy of Ayurvedic inhalation therapy through Nebulization and Rasayana therapy (Rejuvenation therapy) in COPD. Through this study,efforts was made to establish a safer treatment for COPD through herbal drugs. It is also an approach to expand the knowledge of Ayurveda with the help of modern techniques. Trial Registration: CTRI/2017/11/010585. Funding Statement: This study was supported by grants from the MD research program of All India Institute of Ayurveda, New Delhi Declaration of Interests: The authors stated: nil. Ethics Approval Statement: Ethical committee clearance number: AIIA/2017/PG-13.

Application of chronic disease trajectory model nursing in chronic obstructive pulmonary disease

Objective To explore the application value of trajectory nursing of chronic diseases in patients with chronic obstructive pulmonary disease (COPD) . Methods By convenience sampling, a total of 69 COPD patients at the stable stage after treatment in Shangqiu First People's Hospital from January 2016 to January 2018 were selected as research objects, and a total of 66 patients completed the research. According to the communities they belonged to, they were divided into the observation group (n=31) and control group (n=35) . BODE index (B: body mass index; O: airway obstruction; D: dyspnea; E: exercise endurance) was counted in both groups. The patients' COPD disease trajectory in the observation group were evaluated by their scores in BODE and were divided into different stages: 1-2 points were stage I, 3-4 points were stage Ⅱ, 5-7 points were stage Ⅲ, 8-10 points were stage Ⅳ and for those at different stages were given different nursing care with different focus and the control group was given conventional continuous nursing care. The intervention lasted for 3 months, the two groups were compared in their score change status in COPD Assessment Test (CAT) , BODE index, Zarit Burden Interview (ZBI) . Results Before intervention, there was no statistical difference in the two groups' CAT scores, BODE index, and ZBI scores (P>0.05) . After intervention, the CAT score and BODE index, ZBI score in the observation group were lower than the control group with statistical significance (P<0.05) . Conclusions Chronic disease trajectory model is conducive to reducing COPD patients' clinical symptoms and the main caregivers' burden. Key words: Lung disease, chronic obstructive; Chronic disease trajectorymodel; Quality of life; Caregiver burden

Longitudinal Study Of BODE Index As Predictive Factor of COPD In Persahabatan Hospital Jakarta

Background: The BODE index is generally used for predicting mortality risk of COPD patients. The BODE index included the body mass index, degree of airflow obstruction (FEV1), dyspnea (MMRC questionnaire), and exercise capacity (6-minute walk test). Exacerbation of COPD associated with decreased health related quality of life (HRQoL). HRQoL has become an important outcome in respiratory patients as proved by St.George’s Respiratory Questionnaire (SGRQ). This study aim to find the correlation between BODE index with exacerbation and quality of life of COPD patients. We hypothesized that the higher BODE index score, the more frequent exacerbation occurrence and HRQoL decreased.&#x0D; Methods: Prospective cohort study of COPD patients was conducted in Persahabatan Hospital in November 2010 till June 2011. This study assessed the BODE index (at baseline) and followed at 3, 6, 9 and 12 months. Patient were also examined with SGRQ at baseline and followed at 6 and 12 months. We monitored the occurrence of exacerbation every month by telephone, observed their medical record, or visited the COPD’s clinic and emergency departement.&#x0D; Results: Eighty-five patients were examined at baseline with mean of BODE index 4.29 and SGRQ total score 41.42%. After one year follow up 52 patients have completed examination, 29 patients have not complete examination and 4 patients died. Using t-test analysis the correlation of BODE index between single and frequent exacerbation was significant (P

Identification of COPD Phenotypes and BODE Index of Mongolian Miners

Objective: We aimed to investigate the relationship between COPD phenotypes and the BODE index. Methods: A cross-sectional study was performed in 99 patients with COPD. COPD was classified using HRCT into the three morphological phenotypes. Lung function was analyzed by spirometry and the BODE index (Body-mass index, airflow Obstruction, Dyspnea, and Exercise) was calculated. Results: According to the survey, 53 (53.5%) patients had A phenotype, 31 (31.3%) had a M phenotype, and 15 (15.1%) had a E phenotype. Emphysema type has higher BODE index scores. BODE index scores increased significantly with increasing severity of COPD according to the GOLD classification (P&lt;.001). Conclusion: BODE index scores were increased in associating with severity of COPD. Emphysema type COPD has a worse BODE scores than others.

Differences Between COPD Patients of a Pulmonary Rehabilitation Program According to the mMRC Dyspnea Scale

Background: The modified Medical Research Council scale (mMRC) is a standardized measure of the effect of dyspnea on the activities of the daily life of patients suffering from Chronic Obstructive Pulmonary Disease (COPD). The aim of this study was to determine the differences in the quality of life, tolerance to effort and symptoms among patients with COPD with lower (mMRC 0-1) and greater symptoms (mMRC ≥2). Methods: Cross-sectional study that included patients admitted to a pulmonary rehabilitation program and who were classified into 2 groups: a group containing the less symptomatic patients and another group with the more symptomatic ones. We collected these patients’ sociodemographic, clinical, anthropometric, anxiety, depression and quality of life (SGRQ) data. Likewise, the subjects performed the 6-minute walk test (6MWT). Finally, we measured the multidimensional BODE index score. Results: 130 subjects were included, 35 presenting an mMRC of 0 to1 and 95 having an mMRC ≥ 2, with an age of 70.87 ± 9.45 years old. The 6MWT distance, the VO2e, the total score of SGRQ, and its domains of activities and impact showed significant differences between the groups (p &lt;0.05). Significant correlations were found in the group presenting an mMRC of 0-1 between the mMRC and the FEV1 (p = 0.028), and in the group with an mMRC ≥2 for the FVC (p = 0.031), the 6MWT distance (p = 0.000), the VO2e (p = 0.010) and the BODE index (p = 0.000). Conclusion: Patients with an mMRC of 0 to1 had better results in the 6MWT, the VO2e and the SGRQ in comparison with the most symptomatic ones.

Comorbidities in chronic obstructive pulmonary disease: Results of a national multicenter research project

Chronic obstructive pulmonary disease (COPD) is associated with various comorbidities, which influence the course of COPD and worsen prognosis. The aim of this study was to analyze the comorbidities in a cohort of COPD patients in Poland during 12 months of observation. A total of 444 COPD patients (median age: 66.1 years) in all stages of airflow limitation severity were enrolled. Medical histories and a questionnaire concerning comorbidities were analyzed at baseline and after 12 months (data of 267 patients available). Anthropometric data, pulmonary function, and body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE index) were assessed. No comorbidities were reported in 9 patients (2.0%), 101 patients (22.7%) had 1-2 comorbidities, 243 (54.7%) had 3-5, and 91 (20.6%) had more than 5 comorbidities. Cardiovascular diseases (CVDs) were the most frequent ones, followed by peptic ulcer, obstructive sleep apnea (OSA), diabetes, gastroesophageal reflux disease (GERD), and osteoporosis; 11 patients had a history of lung cancer. Cachexia was observed in 11 cases, overweight in 136 cases and obesity in 139 cases. The incidence of CVDs increased with time. The number of comorbidities correlated with the body mass index (BMI) and the number of hospitalizations for extra-pulmonary causes, but not with airflow limitation. The BODE index score increased with the number of comorbidities. In a cohort of Polish COPD patients, the most frequent comorbidities were CVDs. The number of comorbidities affected the BODE index, but not airflow limitation. The BODE index is better than forced expiratory volume in 1 s (FEV1) in the rating of COPD patients' condition. The BMI correlated with the number of comorbidities as well as the number of hospitalizations for extra-pulmonary causes.

Cluster analysis on breath print of newly diagnosed COPD patients: effects of therapy

Background: Chronic obstructive pulmonary disease (COPD) is a highly heterogeneous disease and airflow limitation and symptoms only partially capture such heterogeneity. Since COPD is known to affect the production of volatile organic compounds (VOCs), we aimed to verify to which extent exhaled VOCs can characterize newly diagnosed COPD patients and changes in response to inhaled therapy. Materials and methods: Fifty newly diagnosed COPD patients were consecutively recruited among those attending the pulmonary medicine outpatient clinic at ‘Campus Bio-Medico’ University Hospital. VOCs were collected using the Pneumopipe® and analysed by the BIONOTE electronic nose both at baseline and after 12 weeks of inhaled therapy. Patients were grouped using K-mean cluster analysis on BIONOTE responses and the obtained clusters were compared via non-parametric tests. Results: We identified three clusters of subjects: (a) without remarkable comorbidities; (b) with air trapping and higher BODE index score (mean 1.2); (c) without air trapping and with a lower BODE index. Inhaled bronchodilators caused a quantitative reduction in the amound of VOCs, while inhaled steroids provided a qualitative modification of the breath profile. Conclusion: VOCs patterns categorize newly diagnosed COPD subjects. VOCs production declines after bronchodilators administration and changes in quality after topic steroid treatment.

Replacement of the 6-Min Walk Test With Glittre ADL Test and Scores From the PFSDQ-M and HAP Questionnaires in the BODE Index.

Chronic obstructive pulmonary disease reduces functional capacity, which is strongly correlated with the morbidity and mortality of patients. The BODE index considers the multifactorial nature of the disease, including the functional capacity measured by the 6-min walk test (6MWT), and this index predicts the mortality in patients with chronic obstructive pulmonary disease. Our aim was to assess whether association exists between the original BODE index and the modified BODE index by replacing the 6MWT with the scores from the Pulmonary Functional Status and Dyspnea Questionnaire-Modified version (PFSDQ-M), Human Activity Profile (HAP) questionnaire, and the results of the Glittre ADL Test (TGlittre). Twenty-eight subjects diagnosed with chronic obstructive pulmonary disease underwent the 6MWT and TGlittre and responded to the PFSDQ-M and HAP questionnaires. Four BODE index scores were obtained: 1 calculated by using the original method (ie, using the 6MWT) and 3 others calculated by using the results obtained from the TGlittre, PFSDQ-M, and HAP (the modified BODE index scores). High levels of association were observed between the original BODE index and the BODE TGlittre (R = 0.824, P ≤ .0001), BODE PFSDQ-M (R = 0.803, P ≤ .0001), and BODE HAP (R = 0.500, P ≤ .0001). The BODE TGlittre, and BODE PFSDQ-M may be used as alternatives to the 6MWT when physical space is not available to perform the 6MWT or when the condition of a patient does not allow performance of the 6MWT.

Patterns of Time Use across the Chronic Obstructive Pulmonary Disease Severity Spectrum.

Descriptions of time use patterns in people with chronic obstructive pulmonary disease (COPD) are scarce and the relationship between use-of-time and COPD severity remains unclear. This study aimed to describe a typical day for people with COPD and to explore the differences in time-use patterns across the Body Mass-Index, Airflow Obstruction, Dyspnoea and Exercise Capacity (BODE) index using compositional analyses. Using a cross-sectional design, 141 adults with clinically stable COPD had their demographics, objective measures of function (pulmonary, exercise capacity and physical activity), and self-reported COPD-related impairment recorded. Daily time-use compositions were derived from 24-h accelerometry and 24-h use-of-time recall interviews. Compositional multiple linear regression models were used to explore the relationship between the BODE index and 24-h time-use compositions. These models were used to predict daily time (min/d) that is spent in time-use components across the BODE index. The BODE index score was clearly associated with 24-h accelerometry (p < 0.0001) and 24-h use-of-time recall (p < 0.0001) compositions. Relative to the remaining time-use components, higher BODE index scores were associated with greater sedentary behaviour (p < 0.0001), Quiet time (p < 0.0001), Screen time (p = 0.001) and Self-care (p = 0.022), and less daily Chores (p < 0.0001) and Household administration (p = 0.015) time. As the BODE index scores increased, time-use predictions were strongly associated with decreases in Chores (up to 206 min/d), and increases in Screen (up to 156 min/d) and Quiet time (up to 131 min/d). Time–use patterns may provide a basis for planning interventions relative to the severity of COPD.

Influence of tiotropium bromide on lung function index, quality of life and re-hospitalization risk of patients with bronchial dilation and pulmonary infection

Objective To investigate the influence of tiotropium bromide on lung function index, quality of life and re-hospitalization risk of patients with bronchial dilation and pulmonary infection. Methods 100 patients with bronchiectasis and lung infection were chosen, and they were randomly divided into control group(50 patients) with BAL used alone and observation group(50 patients) with tiotropium bromide on the basis of control group.The short-term clinical effects, the levels of FVC, FEV1 and FEV1%, BODE index scores and QLI scores before and after treatment, and re-hospitalization rate of the two groups were compared. Results The short-term effective rate of the observation group was significantly higher than that of the control group(94.00% vs.76.00%, χ2=7.81, P<0.05). The levels of FVC, FEV1 and FEV1% after treatment of both two groups were significantly higher than before treatment[(2.78±0.57)L vs.(2.15±0.33)L, (3.60±0.71)L vs.(2.20±0.36)L; (2.15±0.42)L vs.(1.23±0.32)L, (2.77±0.59)L vs.(1.17±0.29)L; (65.25±11.45)% vs.(51.79±9.23)%, (77.46±15.80)% vs.(52.02±9.36)%, t=2.34, 2.97; 2.52, 3.07; 2.47, 3.12, all P<0.05]. After treatment, the levels of FVC, FEV1 and FEV1% of the observation group were significantly higher than control group[(3.60±0.71)L vs.(2.78±0.57)L; (2.77±0.59)L vs.(2.15±0.42)L; (77.46±15.80)% vs.(65.25±11.45)%, t=2.26, 2.44, 2.30, all P<0.05]. The QLI score and BODE index scores after treatment of both two groups were significantly better than before treatment[(3.37±0.54)points vs.(3.95±0.65)points, (2.11±0.40)points vs.(3.87±0.61)points, (7.28±1.18)points vs.(5.04±0.95)points, (8.69±1.54)points vs.(5.13±0.98)points, t=2.29, 2.81; 2.50, 2.96, all P<0.05]. After treatment, the QLI score and BODE index scores of the observation group were significantly better than the control group[(2.11±0.40)points vs.(3.37±0.54)points, (8.69±1.54)points vs.(7.28±1.18)points, t=2.21, 2.44, all P<0.05]. The re-hospitalization rate of the observation group was significantly lower than that of the control group(16.00% vs.2.00%; 28.00% vs.6.00%; χ2=8.02, 9.74, all P<0.05). Conclusion Selective cholinergic receptor blocker combined with BAL in the treatment of patients with bronchial dilation and pulmonary infection can efficiently relieve the respiratory symptoms, improve lung function, improve the quality of life and is helpful to avoid re-hospitalization occurrence. Key words: Bronchiectasis; Respiratory tract infections; Quality of life; Tiotropium bromide

The Home COPD and Open Ventilation Evaluation (HOPE) Study

SESSION TITLE: Top Posters - Electronic session SESSION TYPE: Original Investigation Poster PRESENTED ON: Monday, October 30, 2017 at 12:00 PM - 01:30 PM PURPOSE: Respiratory-related diseases, such as COPD, remain a major public health issue affecting millions of people worldwide. Clinical studies have shown that by providing ventilation to reduce respiratory insufficiency symptoms such as dyspnea and high work of breathing, patients may become more tolerant to exercise and be able to increase their functional activity levels, resulting in an overall positive impact to their quality of life. The Life2000 Ventilation System is the only ventilator to simultaneously provide full ventilatory support while enabling patients to ambulate. The HOPE Study was designed to assess the ventilatory efficacy of the Life2000 Ventilation System in patients with COPD. METHODS: This is a single-center, open-label, pilot study in 10 stable, Stage 3 & 4 COPD subjects, as compared to a control group. Subjects were randomized to either continued monitoring alone or monitoring with the use of the Life2000 Ventilation System for a period of six months. The primary endpoints will be the effectiveness of the Life2000 in reducing subjects’ BODE Index and COPD Assessment Test scores, as compared to baseline and control. Subject’s BODE Index and CAT scores will be measured prior to therapy initiation, and again at Days 30, 90, and 180. CAT scores will also be measured after Day 1 of therapy. Secondary endpoints will compare mean pre vs. on-ventilator days’ differences in: Borg Dyspnea Scale Physical Activity Scale for the Elderly(PASE) EtCO2 tracking Reductions in healthcare utilization and costs RESULTS: RESULTS The initial 5 of 10 patients are currently enrolled. Preliminary results at Day 30 show MCID improvement in both primary endpoints compared to baseline: 29% mean decrease in BODE Index (7 vs 5) and 18% mean decrease in CAT Scores (22 vs 18). Clinically significant improvements in median 6MWT Distance (13% or 42m) and post-6MWT Borg dyspnea score (34.6% decrease) at Day 30 as compared to baseline were also seen. Additionally, Day 90 results on the initial 2 patients enrolled showed MCID mean reductions in both BODE Index (31% from 6.4 to 4.5) and CAT Score (41%, from 29 to 17), as compared to baseline. Comparative Day 30 BODE Index scores will be available on all 10 subjects by early May, with Day 90 results available as well on the first 7 enrolled subjects. CONCLUSIONS: The use of a 1-lb, wearable ventilator by COPD patients can play an important role in increasing ambulation and functional activity levels. The Life2000 Ventilation System makes ventilation during activity both practical and achievable for patients, and may result in better disease management, healthcare utilization, and overall outcomes. CLINICAL IMPLICATIONS: The ability to increase functional activity by improving ventilation and oxygenation can result in better management and outcomes for a variety of patient types. DISCLOSURE: Chris Landon: Grant monies (from industry related sources): Sponsored by Breathe Technologies Raymon Gregg: Employee: Breathe Technologies No Product/Research Disclosure Information

Analysis of risk factors for acute exacerbation of chronic obstructive pulmonary disease induced by community-acquired Pseudomonas aeruginosa infection

Objective To study the risk factors of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)induced by community-acquired Pseudomonas aeruginosa(PA)infection which provides the basis for early clinical intervention in high-risk patients. Methods Retrospective analysis of clinical data from 236 patients with acute exacerbation of COPD was conducted in Department of Respiratory Medicine of our hospital from January 2015 to December 2015.The patients were divided into PA group(n=44)and the non-PA group(n=192)according to respiratory tract pathogen infection.The univariate analysis and multivariate logistic regression analysis were performed between the two groups to analyze risk factors for AECOPD induced by PA infection. Results Univariate analysis showed that hypoalbuminemia, AECOPD-induced hospitalization in the recent one year, application of broad spectrum antibiotic within recent 90 days, intermittent use of systemic corticosteroids within recent 90 days, lung function grading of GOLD3/4 level in COPD, acute exacerbation frequency>1 time in last year, the BODE index, walking distance during six minutes, mMRC grading, and CAT scores were significantly correlated with occurrence of community acquired PA-induced AECOPD(all P<0.05). Logistic regression analysis showed that higher BODE index, AECOPD-induced hospitalization in the last year, the use of broad spectrum antibiotic within 90 days and hypoalbuminemia were independent risk factors for community acquired PA induced-AECOPD(OR=14.573、18.958、4.170、5.112, all P<0.05). Conclusions We suggest that the COPD patients having a higher BODE index scores should be clinically intervened early to reduce the occurrence of AECOPD-induced hospitalization, should receive active etiology examination, and should receive therapies for community-acquired Pseudomonas aeruginosa(PA)infection with specific narrow-spectrum antibiotics according to the drug susceptibility and multiple comprehensive measurements, and for correcting hypoalbuminemia. Key words: Pseudomonas aeruginosa; Pulmonary disease chronic obstructive; Risk factors