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Health status deterioration in subjects with mild to moderate airflow obstruction, a six years observational study
BACKGROUND: Patients with COPD need to cope with a disabling disease, which leads to health status impairment. AIM: To investigate the long term change of health status in subjects with mild to moderate airflow obstruction and to compare this to subjects without airflow obstruction, with and without...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6525445/ https://www.ncbi.nlm.nih.gov/pubmed/31103027 http://dx.doi.org/10.1186/s12931-019-1061-7 |
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author | Rodrigues, Fernanda Machado Demeyer, Heleen Loeckx, Matthias Hornikx, Miek Van Remoortel, Hans Janssens, Wim Troosters, Thierry |
author_facet | Rodrigues, Fernanda Machado Demeyer, Heleen Loeckx, Matthias Hornikx, Miek Van Remoortel, Hans Janssens, Wim Troosters, Thierry |
author_sort | Rodrigues, Fernanda Machado |
collection | PubMed |
description | BACKGROUND: Patients with COPD need to cope with a disabling disease, which leads to health status impairment. AIM: To investigate the long term change of health status in subjects with mild to moderate airflow obstruction and to compare this to subjects without airflow obstruction, with and without a smoking history. Second, to investigate the factors potentially associated to rapid health status decline in our total cohort. METHODS: Two hundred and one subjects were included. Generic [Short form 36 health survey (SF36) and EuroQol - 5 dimensions (EQ-5D)] and disease specific [Clinical COPD questionnaire (CCQ) and COPD Assessment Test (CAT)] health status questionnaires were regularly repeated over a six years period. Other functional outcomes comprised measures of lung function, physical fitness, physical activity and emotional state. RESULTS: On average, health status decline did not differ between groups with the exception of the EQ-5D index, which deteriorated faster in subjects with airflow obstruction compared to the never smoking control group [− 0.018(0.008) versus 0.00006(0.003), p = 0.03]. Subjects presenting at least one exacerbation had faster rate of deterioration measured with CAT [0.91(0.21) versus − 0.26(0.25), p < 0.01]. Characteristics of the fast declining group were older age, worse lung function, physical fitness, physical activity and disease specific baseline health status. Subjects with airflow obstruction had a 2.5 (95% CI 1.36–4.71) higher risk of presenting fast overall health status decline. Fast overall decline was associated with the presence of acute exacerbation(s) (44% of the subjects with exacerbation(s) versus 17% of subjects without exacerbation, p = 0.03). Changes in fat free mass, functional exercise capacity and in symptoms of anxiety and depression correlated weakly to changes in health status measured with all questionnaires. CONCLUSION: Subjects with mild airflow obstruction present a significant deterioration of health status, which is generally not much faster compared to smoking and never smoking controls. Subjects with fast decline in overall health status are older and more likely to have airflow obstruction, acute respiratory exacerbation(s), reduced physical fitness, physical activity and impaired COPD specific health status at baseline. TRIAL REGISTRATION: NCT01314807 - retrospectively registered on March 2011. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12931-019-1061-7) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6525445 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-65254452019-05-24 Health status deterioration in subjects with mild to moderate airflow obstruction, a six years observational study Rodrigues, Fernanda Machado Demeyer, Heleen Loeckx, Matthias Hornikx, Miek Van Remoortel, Hans Janssens, Wim Troosters, Thierry Respir Res Research BACKGROUND: Patients with COPD need to cope with a disabling disease, which leads to health status impairment. AIM: To investigate the long term change of health status in subjects with mild to moderate airflow obstruction and to compare this to subjects without airflow obstruction, with and without a smoking history. Second, to investigate the factors potentially associated to rapid health status decline in our total cohort. METHODS: Two hundred and one subjects were included. Generic [Short form 36 health survey (SF36) and EuroQol - 5 dimensions (EQ-5D)] and disease specific [Clinical COPD questionnaire (CCQ) and COPD Assessment Test (CAT)] health status questionnaires were regularly repeated over a six years period. Other functional outcomes comprised measures of lung function, physical fitness, physical activity and emotional state. RESULTS: On average, health status decline did not differ between groups with the exception of the EQ-5D index, which deteriorated faster in subjects with airflow obstruction compared to the never smoking control group [− 0.018(0.008) versus 0.00006(0.003), p = 0.03]. Subjects presenting at least one exacerbation had faster rate of deterioration measured with CAT [0.91(0.21) versus − 0.26(0.25), p < 0.01]. Characteristics of the fast declining group were older age, worse lung function, physical fitness, physical activity and disease specific baseline health status. Subjects with airflow obstruction had a 2.5 (95% CI 1.36–4.71) higher risk of presenting fast overall health status decline. Fast overall decline was associated with the presence of acute exacerbation(s) (44% of the subjects with exacerbation(s) versus 17% of subjects without exacerbation, p = 0.03). Changes in fat free mass, functional exercise capacity and in symptoms of anxiety and depression correlated weakly to changes in health status measured with all questionnaires. CONCLUSION: Subjects with mild airflow obstruction present a significant deterioration of health status, which is generally not much faster compared to smoking and never smoking controls. Subjects with fast decline in overall health status are older and more likely to have airflow obstruction, acute respiratory exacerbation(s), reduced physical fitness, physical activity and impaired COPD specific health status at baseline. TRIAL REGISTRATION: NCT01314807 - retrospectively registered on March 2011. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12931-019-1061-7) contains supplementary material, which is available to authorized users. BioMed Central 2019-05-18 2019 /pmc/articles/PMC6525445/ /pubmed/31103027 http://dx.doi.org/10.1186/s12931-019-1061-7 Text en © The Author(s). 2019 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 Rodrigues, Fernanda Machado Demeyer, Heleen Loeckx, Matthias Hornikx, Miek Van Remoortel, Hans Janssens, Wim Troosters, Thierry Health status deterioration in subjects with mild to moderate airflow obstruction, a six years observational study |
title | Health status deterioration in subjects with mild to moderate airflow obstruction, a six years observational study |
title_full | Health status deterioration in subjects with mild to moderate airflow obstruction, a six years observational study |
title_fullStr | Health status deterioration in subjects with mild to moderate airflow obstruction, a six years observational study |
title_full_unstemmed | Health status deterioration in subjects with mild to moderate airflow obstruction, a six years observational study |
title_short | Health status deterioration in subjects with mild to moderate airflow obstruction, a six years observational study |
title_sort | health status deterioration in subjects with mild to moderate airflow obstruction, a six years observational study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6525445/ https://www.ncbi.nlm.nih.gov/pubmed/31103027 http://dx.doi.org/10.1186/s12931-019-1061-7 |
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