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Degree of dyspnoea at admission and discharge in patients with heart failure and respiratory diseases
BACKGROUND: Dyspnoea is a disabling symptom in patients admitted with heart failure (HF) and respiratory diseases (RD). The main aim of this study is to evaluate its intensity at admission and discharge and the relation with quality of life. We also describe its management, intensity, and evolution...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5441077/ https://www.ncbi.nlm.nih.gov/pubmed/28532487 http://dx.doi.org/10.1186/s12904-017-0208-x |
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author | Vicent, Lourdes Nuñez Olarte, Juan Manuel Puente-Maestu, Luis Oliva, Alicia López, Juan Carlos Postigo, Andrea Martín, Irene Luna, Raquel Fernández-Avilés, Francisco Martínez-Sellés, Manuel |
author_facet | Vicent, Lourdes Nuñez Olarte, Juan Manuel Puente-Maestu, Luis Oliva, Alicia López, Juan Carlos Postigo, Andrea Martín, Irene Luna, Raquel Fernández-Avilés, Francisco Martínez-Sellés, Manuel |
author_sort | Vicent, Lourdes |
collection | PubMed |
description | BACKGROUND: Dyspnoea is a disabling symptom in patients admitted with heart failure (HF) and respiratory diseases (RD). The main aim of this study is to evaluate its intensity at admission and discharge and the relation with quality of life. We also describe its management, intensity, and evolution in HF and RD. METHODS: In this descriptive, cross-sectional study, we included prospectively all patients admitted with decompensated HF and chronic obstructive pulmonary disease (COPD)/pulmonary fibrosis during 4 months. Surveys quantifying dyspnoea (Numerical Rating Scale 1-10) and quality of life (EuroQoL 5d) were administered at discharge. RESULTS: A total of 258 patients were included: 190 (73.6%) with HF and 68 (26.4%) with RD (62 COPD and 6 pulmonary fibrosis). Mean age was 74.0±1.2 years, and 157 (60.6%) were men. Dyspnoea before admission was 7.5±0.1. Patients with RD showed greater dyspnoea than those with HF both before admission (8.1±0.2 vs. 7.3±0.2, p=0.01) and at discharge (3.2±0.3 vs. 2.0±0.2, p=0.0001). They also presented a higher rate of severe dyspnoea (≥5) at discharge (23 [34.3%] vs. 36 [19.1%], p=0.02). Opioids were used in 41 (15.9%), mean dose 8.7±0.8 mg Morphine Equivalent Daily Dose. HF patients had worse EuroQoL 5d scores than those with RD, due to mobility problems (118 [62.1%] vs. 28 [41.8%], p=0.004), and lower punctuation in Visual Analogue Scale (57.9±1.6 vs. 65.6±1.0, p=0.006). CONCLUSIONS: About a quarter of patients admitted with HF or RD persist with severe dyspnoea at discharge. Opioids are probably underused. HF patients have less dyspnoea than patients with RD but present worse quality of life. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12904-017-0208-x) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5441077 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-54410772017-05-24 Degree of dyspnoea at admission and discharge in patients with heart failure and respiratory diseases Vicent, Lourdes Nuñez Olarte, Juan Manuel Puente-Maestu, Luis Oliva, Alicia López, Juan Carlos Postigo, Andrea Martín, Irene Luna, Raquel Fernández-Avilés, Francisco Martínez-Sellés, Manuel BMC Palliat Care Research Article BACKGROUND: Dyspnoea is a disabling symptom in patients admitted with heart failure (HF) and respiratory diseases (RD). The main aim of this study is to evaluate its intensity at admission and discharge and the relation with quality of life. We also describe its management, intensity, and evolution in HF and RD. METHODS: In this descriptive, cross-sectional study, we included prospectively all patients admitted with decompensated HF and chronic obstructive pulmonary disease (COPD)/pulmonary fibrosis during 4 months. Surveys quantifying dyspnoea (Numerical Rating Scale 1-10) and quality of life (EuroQoL 5d) were administered at discharge. RESULTS: A total of 258 patients were included: 190 (73.6%) with HF and 68 (26.4%) with RD (62 COPD and 6 pulmonary fibrosis). Mean age was 74.0±1.2 years, and 157 (60.6%) were men. Dyspnoea before admission was 7.5±0.1. Patients with RD showed greater dyspnoea than those with HF both before admission (8.1±0.2 vs. 7.3±0.2, p=0.01) and at discharge (3.2±0.3 vs. 2.0±0.2, p=0.0001). They also presented a higher rate of severe dyspnoea (≥5) at discharge (23 [34.3%] vs. 36 [19.1%], p=0.02). Opioids were used in 41 (15.9%), mean dose 8.7±0.8 mg Morphine Equivalent Daily Dose. HF patients had worse EuroQoL 5d scores than those with RD, due to mobility problems (118 [62.1%] vs. 28 [41.8%], p=0.004), and lower punctuation in Visual Analogue Scale (57.9±1.6 vs. 65.6±1.0, p=0.006). CONCLUSIONS: About a quarter of patients admitted with HF or RD persist with severe dyspnoea at discharge. Opioids are probably underused. HF patients have less dyspnoea than patients with RD but present worse quality of life. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12904-017-0208-x) contains supplementary material, which is available to authorized users. BioMed Central 2017-05-22 /pmc/articles/PMC5441077/ /pubmed/28532487 http://dx.doi.org/10.1186/s12904-017-0208-x Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Vicent, Lourdes Nuñez Olarte, Juan Manuel Puente-Maestu, Luis Oliva, Alicia López, Juan Carlos Postigo, Andrea Martín, Irene Luna, Raquel Fernández-Avilés, Francisco Martínez-Sellés, Manuel Degree of dyspnoea at admission and discharge in patients with heart failure and respiratory diseases |
title | Degree of dyspnoea at admission and discharge in patients with heart failure and respiratory diseases |
title_full | Degree of dyspnoea at admission and discharge in patients with heart failure and respiratory diseases |
title_fullStr | Degree of dyspnoea at admission and discharge in patients with heart failure and respiratory diseases |
title_full_unstemmed | Degree of dyspnoea at admission and discharge in patients with heart failure and respiratory diseases |
title_short | Degree of dyspnoea at admission and discharge in patients with heart failure and respiratory diseases |
title_sort | degree of dyspnoea at admission and discharge in patients with heart failure and respiratory diseases |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5441077/ https://www.ncbi.nlm.nih.gov/pubmed/28532487 http://dx.doi.org/10.1186/s12904-017-0208-x |
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