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dc.contributor.authorWilke, Sarah-
dc.contributor.authorJones, Paul W.-
dc.contributor.authorMüllerova, H.-
dc.contributor.authorVestbo, Jørgen-
dc.contributor.authorTal-Singer, Ruth-
dc.contributor.authorFranssen, Frits M.E.-
dc.contributor.authorAgustí García-Navarro, Àlvar-
dc.contributor.authorBakke, Per-
dc.contributor.authorCalverley, Peter M.-
dc.contributor.authorCoxson, Harvey O.-
dc.contributor.authorCrim, Courtney-
dc.contributor.authorEdwards, Lisa D.-
dc.contributor.authorLomas, David A.-
dc.contributor.authorMacNee, William-
dc.contributor.authorRennard, Stephen I.-
dc.contributor.authorYates, Julie C.-
dc.contributor.authorWouters, Emiel-
dc.contributor.authorSpruit, Martijn A.-
dc.description.abstractBACKGROUND: 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.-
dc.format.extent7 p.-
dc.publisherBMJ Publishing Group-
dc.relation.isformatofReproducció del document publicat a:
dc.relation.ispartofThorax, 2015, vol. 70, num. 5, p. 420-425-
dc.rights(c) BMJ Publishing Group, 2015-
dc.subject.classificationMalalties pulmonars obstructives cròniques-
dc.subject.classificationSalut pública-
dc.subject.otherChronic obstructive pulmonary diseases-
dc.subject.otherPublic health-
dc.titleOne-year change in health status and subsequent outcomes in COPD-
Appears in Collections:Articles publicats en revistes (Medicina)

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