Please use this identifier to cite or link to this item: http://hdl.handle.net/2445/105786
Title: One-year change in health status and subsequent outcomes in COPD
Author: Wilke, Sarah
Jones, Paul W.
Müllerova, H.
Vestbo, Jørgen
Tal-Singer, Ruth
Franssen, Frits M.E.
Agustí García-Navarro, Àlvar
Bakke, Per
Calverley, Peter M.
Coxson, Harvey O.
Crim, Courtney
Edwards, Lisa D.
Lomas, David A.
MacNee, William
Rennard, Stephen I.
Yates, Julie C.
Wouters, Emiel
Spruit, Martijn A.
Keywords: Malalties pulmonars obstructives cròniques
Salut pública
Mortalitat
Morbiditat
Chronic obstructive pulmonary diseases
Public health
Mortality
Morbidity
Issue Date: May-2015
Publisher: BMJ Publishing Group
Abstract: BACKGROUND: Poor health status has been associated with morbidity and mortality in patients with COPD. To date, the impact of changes in health status on these outcomes remains unknown. AIMS: To explore the relationship of clinically relevant changes in health status with exacerbation, hospitalisation or death in patients with COPD. METHODS: Characteristics and health status (St George's Respiratory Questionnaire, SGRQ) were assessed over a period of 3 years in 2138 patients with COPD enrolled in the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study: a longitudinal, prospective, observational study. Associations between change in health status (=4 units in SGRQ score) during year 1 and time to first exacerbation, hospitalisation and death during 2-year follow-up were assessed using Kaplan-Meier plots and log-rank test. RESULTS: 1832 (85.7%) patients (age 63.4±7.0 years, 65.4% male, FEV1 48.7±15.6% predicted) underwent assessment at baseline and 1 year. Compared with those who deteriorated, patients with improved or stable health status in year 1 have a lower likelihood of exacerbation (HR 0.78 (95% CI 0.67 to 0.89), p<0.001 and 0.84 (0.73 to 0.97), p=0.016, respectively), hospitalisation (0.72 (0.58 to 0.90), p=0.004 and 0.77 (0.62 to 0.96), p=0.023, respectively) or dying (0.61 (0.39 to 0.95), p=0.027 and 0.58 (0.37 to 0.92), p=0.019, respectively) during 2-year follow-up. This effect persisted after stratification for age and the number of exacerbations and hospitalisations during the first year of the study. CONCLUSIONS: Patients with stable or improved health status during year 1 of ECLIPSE had a lower likelihood of exacerbation, hospitalisation or dying during 2-year follow-up. Interventions that stabilise and improve health status may also improve outcomes in patients with COPD.
Note: Reproducció del document publicat a: https://doi.org/10.1136/thoraxjnl-2014-205697
It is part of: Thorax, 2015, vol. 70, num. 5, p. 420-425
Related resource: https://doi.org/10.1136/thoraxjnl-2014-205697
URI: http://hdl.handle.net/2445/105786
ISSN: 0040-6376
Appears in Collections:Articles publicats en revistes (Medicina)

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