Cargando…

Life-Space mobility and clinical outcomes in COPD

BACKGROUND: Social isolation is a common experience in patients with COPD but is not captured by existing patient-reported outcomes, and its association with clinical outcomes is unknown. METHODS: We prospectively enrolled adults with stable COPD who completed the University of Alabama at Birmingham...

Descripción completa

Detalles Bibliográficos
Autores principales: Iyer, Anand S, Wells, James M, Bhatt, Surya P, Kirkpatrick, deNay P, Sawyer, Patricia, Brown, Cynthia J, Allman, Richard M, Bakitas, Marie A, Dransfield, Mark T
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6130264/
https://www.ncbi.nlm.nih.gov/pubmed/30233163
http://dx.doi.org/10.2147/COPD.S170887
_version_ 1783353907302367232
author Iyer, Anand S
Wells, James M
Bhatt, Surya P
Kirkpatrick, deNay P
Sawyer, Patricia
Brown, Cynthia J
Allman, Richard M
Bakitas, Marie A
Dransfield, Mark T
author_facet Iyer, Anand S
Wells, James M
Bhatt, Surya P
Kirkpatrick, deNay P
Sawyer, Patricia
Brown, Cynthia J
Allman, Richard M
Bakitas, Marie A
Dransfield, Mark T
author_sort Iyer, Anand S
collection PubMed
description BACKGROUND: Social isolation is a common experience in patients with COPD but is not captured by existing patient-reported outcomes, and its association with clinical outcomes is unknown. METHODS: We prospectively enrolled adults with stable COPD who completed the University of Alabama at Birmingham Life Space Assessment (LSA) (range: 0–120, restricted Life-Space mobility: ≤60 and a marker of social isolation in older adults); six-minute walk test (6MWT), and the University of California at San Diego Shortness of Breath Questionnaire, COPD Assessment Test, and Hospital Anxiety and Depression Scale. The occurrence of severe exacerbations (emergency room visit or hospitalization) was recorded by review of the electronic record up to 1 year after enrollment. We determined associations between Life-Space mobility and clinical outcomes using regression analyses. RESULTS: Fifty subjects had a mean ± SD %-predicted FEV(1) of 42.9±15.5, and 23 (46%) had restricted Life-Space mobility. After adjusting for age, gender, %-predicted FEV(1), comorbidity count, inhaled corticosteroid/long-acting beta(2)-agonist use, and prior cardiopulmonary rehabilitation, subjects with restricted Life-Space had an increased risk for severe exacerbations (adjusted incidence rate ratio 4.65, 95% CI 1.19–18.23, P=0.03). LSA scores were associated with 6MWD (R=0.50, P<0.001), dyspnea (R=−0.58, P<0.001), quality of life (R=−0.34, P=0.02), and depressive symptoms (R=−0.39, P=0.005). CONCLUSION: Restricted Life-Space mobility predicts severe exacerbations and is associated with reduced exercise tolerance, more severe dyspnea, reduced quality of life, and greater depressive symptoms.
format Online
Article
Text
id pubmed-6130264
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Dove Medical Press
record_format MEDLINE/PubMed
spelling pubmed-61302642018-09-19 Life-Space mobility and clinical outcomes in COPD Iyer, Anand S Wells, James M Bhatt, Surya P Kirkpatrick, deNay P Sawyer, Patricia Brown, Cynthia J Allman, Richard M Bakitas, Marie A Dransfield, Mark T Int J Chron Obstruct Pulmon Dis Original Research BACKGROUND: Social isolation is a common experience in patients with COPD but is not captured by existing patient-reported outcomes, and its association with clinical outcomes is unknown. METHODS: We prospectively enrolled adults with stable COPD who completed the University of Alabama at Birmingham Life Space Assessment (LSA) (range: 0–120, restricted Life-Space mobility: ≤60 and a marker of social isolation in older adults); six-minute walk test (6MWT), and the University of California at San Diego Shortness of Breath Questionnaire, COPD Assessment Test, and Hospital Anxiety and Depression Scale. The occurrence of severe exacerbations (emergency room visit or hospitalization) was recorded by review of the electronic record up to 1 year after enrollment. We determined associations between Life-Space mobility and clinical outcomes using regression analyses. RESULTS: Fifty subjects had a mean ± SD %-predicted FEV(1) of 42.9±15.5, and 23 (46%) had restricted Life-Space mobility. After adjusting for age, gender, %-predicted FEV(1), comorbidity count, inhaled corticosteroid/long-acting beta(2)-agonist use, and prior cardiopulmonary rehabilitation, subjects with restricted Life-Space had an increased risk for severe exacerbations (adjusted incidence rate ratio 4.65, 95% CI 1.19–18.23, P=0.03). LSA scores were associated with 6MWD (R=0.50, P<0.001), dyspnea (R=−0.58, P<0.001), quality of life (R=−0.34, P=0.02), and depressive symptoms (R=−0.39, P=0.005). CONCLUSION: Restricted Life-Space mobility predicts severe exacerbations and is associated with reduced exercise tolerance, more severe dyspnea, reduced quality of life, and greater depressive symptoms. Dove Medical Press 2018-09-04 /pmc/articles/PMC6130264/ /pubmed/30233163 http://dx.doi.org/10.2147/COPD.S170887 Text en © 2018 Iyer et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Iyer, Anand S
Wells, James M
Bhatt, Surya P
Kirkpatrick, deNay P
Sawyer, Patricia
Brown, Cynthia J
Allman, Richard M
Bakitas, Marie A
Dransfield, Mark T
Life-Space mobility and clinical outcomes in COPD
title Life-Space mobility and clinical outcomes in COPD
title_full Life-Space mobility and clinical outcomes in COPD
title_fullStr Life-Space mobility and clinical outcomes in COPD
title_full_unstemmed Life-Space mobility and clinical outcomes in COPD
title_short Life-Space mobility and clinical outcomes in COPD
title_sort life-space mobility and clinical outcomes in copd
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6130264/
https://www.ncbi.nlm.nih.gov/pubmed/30233163
http://dx.doi.org/10.2147/COPD.S170887
work_keys_str_mv AT iyeranands lifespacemobilityandclinicaloutcomesincopd
AT wellsjamesm lifespacemobilityandclinicaloutcomesincopd
AT bhattsuryap lifespacemobilityandclinicaloutcomesincopd
AT kirkpatrickdenayp lifespacemobilityandclinicaloutcomesincopd
AT sawyerpatricia lifespacemobilityandclinicaloutcomesincopd
AT browncynthiaj lifespacemobilityandclinicaloutcomesincopd
AT allmanrichardm lifespacemobilityandclinicaloutcomesincopd
AT bakitasmariea lifespacemobilityandclinicaloutcomesincopd
AT dransfieldmarkt lifespacemobilityandclinicaloutcomesincopd