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Impact of COPD exacerbations leading to hospitalization on general and disease-specific quality of life - 21/09/21

Doi : 10.1016/j.rmed.2021.106526 
Erin R. Camac a, , Helen Voelker b , Gerard J. Criner a

for the COPD Clinical Research Network and the Canadian Institutes of Health Research

a Lewis Katz School of Medicine at Temple University, Department of Thoracic Medicine and Surgery, Division of Pulmonary and Critical Care Medicine, 3401 North Broad Street Philadelphia, PA, 19140, USA 
b University of Minnesota, Minneapolis, MN, USA 

Corresponding author.

Abstract

Rationale

Acute exacerbations negatively impact quality of life in patients with chronic obstructive pulmonary disease (COPD), but the impact of hospitalized exacerbations on quality of life is not clear. We hypothesized that patients with hospitalized exacerbations would benefit from hospitalization and experience improvement in general and disease-specific quality of life (as measured by the St. George's respiratory questionnaire (SGRQ) and the medical outcomes study 36-item short form health survey (SF-36)) compared to those without exacerbations, or with non-hospitalized acute exacerbations.

Methods

1219 COPD patients enrolled in either the simvastatin for the prevention of exacerbations in moderate-to severe COPD Trial (STATCOPE) or azithromycin for prevention of exacerbations of COPD trial (MACRO) were analyzed. Demographic information, spirometry, and symptom scores were noted at baseline. Exacerbation events and changes in quality of life scores were assessed over a mean of 538 days of follow-up.

Results

Of patients studied, 25.6% were hospitalized, 44.0% had at least one outpatient exacerbation, and 30.4% had no exacerbation. Baseline SGRQ and SF-36 scores were severely impaired in all groups studied. Over time, SF-36 scores did not change significantly between groups. SGRQ symptom domain scores improved in other groups but did not improve in those hospitalized for a COPD exacerbation.

Conclusions

At baseline, patients hospitalized for acute exacerbations of COPD had more impaired quality of life scores. Over time, SGRQ symptom domain scores improved in other groups but did not in those who were hospitalized. Other measurements of quality of life were not improved by hospitalization for COPD.

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Highlights

Acute exacerbations negatively impact quality of life in patients with COPD.
The relative impact of hospitalized exacerbations on quality of life is not clear.
Quality of life and symptom scores were severely reduced in all COPD patients at baseline.
Patients with hospitalized exacerbations did not experience improvements in quality of life.
Patients without exacerbations experienced improved disease-specific quality of life symptom scores.

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Résumé

These data were presented as an Abstract at the American Thoracic Society International Conference in San Diego, California, on May 15, 2015. This manuscript has not been submitted, nor is it under consideration, for any other journal.

Le texte complet de cet article est disponible en PDF.

Keywords : COPD, AECOPD, Hospitalization, Quality of Life, SGRQ, SF-36

Abbreviations : AECOPD, ATS, BMI, CI, COPD, ERS, FEV1, GOLD, ICS, LABA, LAMA, MACRO, MCID, SABA, SD, SGRQ, SF-36, STATCOPE


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Vol 186

Article 106526- septembre 2021 Retour au numéro
Article précédent Article précédent
  • Large underreporting of COPD as cause of death-results from a population-based cohort study
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  • Signe Vedel-Krogh, Sune Fallgaard Nielsen, Børge Grønne Nordestgaard, Peter Lange, Jørgen Vestbo

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