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Current Respiratory Medicine Reviews

Editor-in-Chief

ISSN (Print): 1573-398X
ISSN (Online): 1875-6387

Research Article

Clinical and Quality of Life Differences in Patients with COPD With and Without a Background of Hospitalization in the Last Year

Author(s): Jhonatan Betancourt-Peña*, Juan Carlos Ávila-Valencia, Jorge Karim Assis and David Alejandro Escobar-Vidal

Volume 16, Issue 4, 2020

Page: [228 - 233] Pages: 6

DOI: 10.2174/1573398X17666210209111111

Price: $65

Abstract

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading cause of death worldwide. An upward trend is estimated by 2030. One of the causes of mortality is the exacerbations of symptoms that result in hospitalizations. These hospitalizations reduce the quality of life, limit performance in daily life, and increase the costs for the health system and the patient.

Objective: This study aimed to determine the differences between hospitalized and non-hospitalized patients with a medical diagnosis of COPD, considering some sociodemographic and clinical variables, and survival rates.

Methods: A cross-sectional study was conducted, which included patients diagnosed with COPD who initiated pulmonary rehabilitation (PR) from January to September 2018. The patients were divided into two groups: patients with one or more exacerbations that led to the hospitalization (COPD-H) and patients without hospitalizations in the last year (COPD-NH).

Results: There were 128 participants (78 males and 50 females), with a mean age of 71.10±(9.34) in the COPD-H group and 71.30±(8.91) in the COPD-NH group. When comparing both groups, COPD-NH had a higher socioeconomic status (p=0.041), reporting a higher FEV1 44.71± (14.97), p=0.047, and comorbidities according to the COTE index (p<0.001).

Conclusions: The patients with the highest number of hospitalizations belonged to a lower socioeconomic stratum and had a higher number of comorbidities. Therefore, it is necessary to identify these factors at the beginning of PR.

Keywords: Obstructive pulmonary disease, hospitalization, quality of life, comorbidity, exercise test, COPD.

Graphical Abstract
[1]
World Health Organization. WHO Chronic obstructive pulmonary disease (COPD): Key facts 2017. Available from: https://www.who.int/es/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(COPD)
[2]
Pan American Health Organization. PAHO Non-communicable diseases news. In: In: the Americas, tobacco is linked to 7 in 10 deaths from chronic obstructive pulmonary disease. 2012. Available from: https://www.paho.org/hq/index.php?
[3]
Kim V, Aaron SD. What is a COPD exacerbation? Current definitions, pitfalls, challenges and opportunities for improvement. Eur Respir J 2018; 52(5): 1801261.
[http://dx.doi.org/10.1183/13993003.01261-2018] [PMID: 30237306]
[4]
Botero S, Restrepo DA. Conceptos esenciales de la EPOC, prevalencia e impacto en AmA(c)rica Latina. Med UPB 2015; 34: 49-60. Available from: https://www.redalyc.org/pdf/1590/159046025007.pdf
[5]
Foo J, Landis SH, Maskell J, et al. Continuing to Confront COPD International Patient Survey: Economic Impact of COPD in 12 Countries. PLoS One 2016; 11(4): e0152618.
[http://dx.doi.org/10.1371/journal.pone.0152618] [PMID: 27092775]
[6]
Terzano C, Colamesta V, Unim B, et al. Chronic obstructive pulmonary disease (COPD) exacerbation: impact of comorbidities on length and costs during hospitalization. Eur Rev Med Pharmacol Sci 2017; 21(16): 3680-9.
[PMID: 28925473]
[7]
Stallberg B, Janson C, Larsson K, et al. Real-world retrospective cohort study ARCTIC shows burden of comorbidities in Swedish COPD versus non-COPD patients. NPJ Prim Care Respir Med 2018; 28(1): 33.
[http://dx.doi.org/10.1038/s41533-018-0101-y] [PMID: 30202023]
[8]
Casaburi R. Pulmonary Rehabilitation: Where we've succeeded and where we've failed. COPD 2018; 15(3): 219-22.
[http://dx.doi.org/10.1080/15412555.2018.1503245] [PMID: 30183413]
[9]
Ramos M, Lamotte M, Gerlier L, Svangren P, Miquel-Cases A, Haughney J. Cost-effectiveness of physical activity in the management of COPD patients in the UK. Int J Chron Obstruct Pulmon Dis 2019; 14: 227-39.
[http://dx.doi.org/10.2147/COPD.S181194] [PMID: 30697043]
[10]
McCarthy B, Casey D, Devane D, Murphy K, Murphy E, Lacasse Y. Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2015; 2(2): CD003793.
[http://dx.doi.org/10.1002/14651858.CD003793.pub3] [PMID: 25705944]
[11]
Rochester CL, Vogiatzis I, Holland AE, et al. An official american thoracic society/european respiratory society policy statement: enhancing implementation, use, and delivery of pulmonary rehabilitation. Am J Respir Crit Care Med 2015; 192(11): 1373-86.
[http://dx.doi.org/10.1164/rccm.201510-1966ST] [PMID: 26623686]
[12]
Global Strategy for the Diagnosis, Management, and Prevention of COPD - Global Initiative for Chronic Obstructive Lung Disease - GOLD 2020. Available from: https://goldcopd.org/wp-content/uploads/2019/12/GOLD-2020-FINAL-ver1.2-03Dec19_WMV.pdf
[13]
Graham BL, Steenbruggen I, Miller MR, et al. Standardization of Spirometry 2019 Update. An official american thoracic society and european respiratory society technical statement. Am J Respir Crit Care Med 2019; 200(8): e70-88.
[http://dx.doi.org/10.1164/rccm.201908-1590ST] [PMID: 31613151]
[14]
American College of Sports Medicine. ACSM's guidelines for exercise testing and prescription. 10th ed. Lippincott, Williams & Wilkins 2017.
[15]
Paap MC, Brouwer D, Glas CA, et al. The St George's Respiratory Questionnaire revisited: a psychometric evaluation. Qual Life Res 2015; 24(1): 67-79.
[http://dx.doi.org/10.1007/s11136-013-0570-y] [PMID: 24241770]
[16]
Divo M, Cote C, de Torres JP, et al. Comorbidities and risk of mortality in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2012; 186(2): 155-61.
[http://dx.doi.org/10.1164/rccm.201201-0034OC] [PMID: 22561964]
[17]
Celli BR, Cote CG, Marin JM, et al. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med 2004; 350(10): 1005-12.
[http://dx.doi.org/10.1056/NEJMoa021322] [PMID: 14999112]
[18]
Tejero A, Guimera E, Farre J, Peri J. Uso clA-nico del HAD (Hospital Anxiety and Depression Scale) en poblacion psiquiatrica: un estudio de su sensibilidad, fiabilidad y validez. Rev Psiquiatr Fac Med Barc 1986; 13: 233-8.
[19]
Garcia-Sanz MT, Gonzalez-Barcala FJ, Canive-Gomez JC, Garcia-Couceiro N, Alonso-Acuna S, Carreira JM. Prolonged stay predictors in patients admitted with chronic obstructive pulmonary disease acute exacerbation. Lung India 2018; 35(4): 316-20.
[http://dx.doi.org/10.4103/lungindia.lungindia_469_17] [PMID: 29970771]
[20]
Hunter LC, Lee RJ, Butcher I, et al. Patient characteristics associated with risk of first hospital admission and readmission for acute exacerbation of chronic obstructive pulmonary disease (COPD) following primary care COPD diagnosis: a cohort study using linked electronic patient records. BMJ Open 2016; 6(1): e009121.
[http://dx.doi.org/10.1136/bmjopen-2015-009121] [PMID: 26801463]
[21]
Czajka R, Saralaya D, Regan K, Walker L. Chronic obstructive pulmonary disease (COPD) risk stratification among hospitalised COPD exacerbators: a bradford experience. Am J Respir Crit Care Med 2016; 193: A2014. Available from: https://www.atsjournals.org/doi/abs/10.1164/ajrccm-conference.2016.193.1_MeetingAbstracts. A2014
[22]
Corsico AG, Braido F, Contoli M, et al. Healthcare costs of the SATisfaction and adherence to COPD treatment (SAT) study follow-up. Respir Med 2019; 153: 68-75.
[http://dx.doi.org/10.1016/j.rmed.2019.05.017] [PMID: 31174106]
[23]
Byng D, Lutter JI, Wacker ME, et al. Determinants of healthcare utilization and costs in COPD patients: first longitudinal results from the German COPD cohort COSYCONET. Int J Chron Obstruct Pulmon Dis 2019; 14: 1423-39.
[http://dx.doi.org/10.2147/COPD.S201899] [PMID: 31308648]
[24]
Hogea-Stanca P, Tudorache E, Fildan AP, Fira-Mladinescu O, Marc M, Oancea C. Risk factors of chronic obstructive pulmonary disease exacerbations. Clin Respir J 2019; 14(3): 183-97.
[http://dx.doi.org/10.1111/crj.13129]
[25]
Donahue JF. Forced expiratory volume in one second and patient-reported outcomes: closer than you think. Chronic Obstr Pulm Dis (Miami) 2016; 3(2): 512-4.
[http://dx.doi.org/10.15326/jcopdf.3.2.2016.0144] [PMID: 28848876]
[26]
Moberg M, Vestbo J, Martinez G, et al. Validation of the i-BODE index as a predictor of hospitalization and mortality in patients with COPD participating in pulmonary rehabilitation. COPD 2014; 11(4): 381-7.
[http://dx.doi.org/10.3109/15412555.2013.836171] [PMID: 24111845]
[27]
Andrianopoulos V, Wouters EF, Pinto-Plata VM, et al. Prognostic value of variables derived from the six-minute walk test in patients with COPD: Results from the ECLIPSE study. Respir Med 2015; 109(9): 1138-46.
[http://dx.doi.org/10.1016/j.rmed.2015.06.013] [PMID: 26143282]
[28]
Betancourt-Pena J, Tonguino-Rosero S. Impacto de la oxigenoterapia domiciliaria en la capacidad funcional de pacientes con enfermedad pulmonar obstructiva crónica. Rev reha 2016; 50: 13-8.
[http://dx.doi.org/10.1016/j.rh.2015.10.001]
[29]
Narewski ER, Voelker H, Nayeemuddin M, Albert RK, Connett JE, Bailey WC. Short-term impact of hospitalized vs non-hospitalized COPD exacerbations on general and disease-specific quality of life. Am J Respir Crit Care Med 2015; 191: A2538. Available from: https://www.atsjournals.org/doi/abs/10.1164/ajrccm-conference.2015.191.1_MeetingAbstracts.A2538
[30]
Betancourt-Pena J, Rodriguez-Castro J, Escobar-Vidal DA. Diferencias entre pacientes con EPOC no adherentes y adherentes al tratamiento farmacológico según la GOLD 2018 en variables clínicas, los índices CODEX, COTE y BODE. Fisioterapia 2020; 42(1): 24-32.
[http://dx.doi.org/10.1016/j.ft.2019.10.005]

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