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Prevalence of Frailty and Evaluation of Associated Variables Among COPD Patients
RATIONALE: Frailty in chronic obstructive pulmonary disease (COPD) patients has been associated with a higher rate of incidents, longer duration of hospitalization, poorer quality of life, and higher mortality. OBJECTIVE: To measure the prevalence of frailty among COPD patients and to evaluate assoc...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7297564/ https://www.ncbi.nlm.nih.gov/pubmed/32606644 http://dx.doi.org/10.2147/COPD.S250299 |
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author | Dias, Lara de Souza Ferreira, Anna Carolina Galvão da Silva Junior, José Laerte Rodrigues Conte, Marcus Barreto Rabahi, Marcelo Fouad |
author_facet | Dias, Lara de Souza Ferreira, Anna Carolina Galvão da Silva Junior, José Laerte Rodrigues Conte, Marcus Barreto Rabahi, Marcelo Fouad |
author_sort | Dias, Lara de Souza |
collection | PubMed |
description | RATIONALE: Frailty in chronic obstructive pulmonary disease (COPD) patients has been associated with a higher rate of incidents, longer duration of hospitalization, poorer quality of life, and higher mortality. OBJECTIVE: To measure the prevalence of frailty among COPD patients and to evaluate associated variables. METHODS: A cross-sectional study. Subjects who visited a State Center for High-Cost Medicines to obtain free monthly COPD medicines were considered eligible. Individuals ≥40 years old who had a FEV(1)/FVC ratio of <0.7 post-bronchodilation were enrolled. The Fatigue, Resistance, Ambulation, Illnesses, and Loss of weight (FRAIL) scale, Medical Research Council dyspnea scale (MRC), COPD Assessment Test (CAT), a combination of CAT/MRC [(CAT/8)+MRC], and the Global Initiative for Chronic Obstructive Lung Disease (GOLD) severity scale were used to evaluate the enrolled subjects. Variables associated with frailty were analyzed using an ordered logistic regression and a multivariate logistic regression. RESULTS: The prevalence of frailty and pre-frailty among the 153 COPD subjects enrolled was 50.3% (77/153) and 35.3% (54/153), respectively. Frailty scores were correlated with CAT (correlation coefficient [cc]: 0.52, p <0.001) and MRC (cc: 0.48, p <0.001). Ordinal regression models showed that MRC and CAT were associated with fragility (p <0.0001 for both models). Higher odds of frailty were observed in GOLD groups B (p = 0.04) and D (p = 0.02). Multiple logistic regression revealed that the combination CAT/MRC≥5.5 was associated with frailty (OR 6.73; p <0.0001) and had a specificity of 80.3%, sensitivity of 62.3%, and positive and negative predictive values of 76.2% and67.8%, respectively. CONCLUSION: Frailty prevalence was high and was correlated with higher MRC and CAT scores. The CAT/MRC combination [(CAT/8)+MRC] ≥5.5 was highly associated with frailty, suggesting that an additional specific evaluation for the presence of frailty is indicated. |
format | Online Article Text |
id | pubmed-7297564 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Dove |
record_format | MEDLINE/PubMed |
spelling | pubmed-72975642020-06-29 Prevalence of Frailty and Evaluation of Associated Variables Among COPD Patients Dias, Lara de Souza Ferreira, Anna Carolina Galvão da Silva Junior, José Laerte Rodrigues Conte, Marcus Barreto Rabahi, Marcelo Fouad Int J Chron Obstruct Pulmon Dis Original Research RATIONALE: Frailty in chronic obstructive pulmonary disease (COPD) patients has been associated with a higher rate of incidents, longer duration of hospitalization, poorer quality of life, and higher mortality. OBJECTIVE: To measure the prevalence of frailty among COPD patients and to evaluate associated variables. METHODS: A cross-sectional study. Subjects who visited a State Center for High-Cost Medicines to obtain free monthly COPD medicines were considered eligible. Individuals ≥40 years old who had a FEV(1)/FVC ratio of <0.7 post-bronchodilation were enrolled. The Fatigue, Resistance, Ambulation, Illnesses, and Loss of weight (FRAIL) scale, Medical Research Council dyspnea scale (MRC), COPD Assessment Test (CAT), a combination of CAT/MRC [(CAT/8)+MRC], and the Global Initiative for Chronic Obstructive Lung Disease (GOLD) severity scale were used to evaluate the enrolled subjects. Variables associated with frailty were analyzed using an ordered logistic regression and a multivariate logistic regression. RESULTS: The prevalence of frailty and pre-frailty among the 153 COPD subjects enrolled was 50.3% (77/153) and 35.3% (54/153), respectively. Frailty scores were correlated with CAT (correlation coefficient [cc]: 0.52, p <0.001) and MRC (cc: 0.48, p <0.001). Ordinal regression models showed that MRC and CAT were associated with fragility (p <0.0001 for both models). Higher odds of frailty were observed in GOLD groups B (p = 0.04) and D (p = 0.02). Multiple logistic regression revealed that the combination CAT/MRC≥5.5 was associated with frailty (OR 6.73; p <0.0001) and had a specificity of 80.3%, sensitivity of 62.3%, and positive and negative predictive values of 76.2% and67.8%, respectively. CONCLUSION: Frailty prevalence was high and was correlated with higher MRC and CAT scores. The CAT/MRC combination [(CAT/8)+MRC] ≥5.5 was highly associated with frailty, suggesting that an additional specific evaluation for the presence of frailty is indicated. Dove 2020-06-12 /pmc/articles/PMC7297564/ /pubmed/32606644 http://dx.doi.org/10.2147/COPD.S250299 Text en © 2020 Dias et al. http://creativecommons.org/licenses/by-nc/3.0/ 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. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). |
spellingShingle | Original Research Dias, Lara de Souza Ferreira, Anna Carolina Galvão da Silva Junior, José Laerte Rodrigues Conte, Marcus Barreto Rabahi, Marcelo Fouad Prevalence of Frailty and Evaluation of Associated Variables Among COPD Patients |
title | Prevalence of Frailty and Evaluation of Associated Variables Among COPD Patients |
title_full | Prevalence of Frailty and Evaluation of Associated Variables Among COPD Patients |
title_fullStr | Prevalence of Frailty and Evaluation of Associated Variables Among COPD Patients |
title_full_unstemmed | Prevalence of Frailty and Evaluation of Associated Variables Among COPD Patients |
title_short | Prevalence of Frailty and Evaluation of Associated Variables Among COPD Patients |
title_sort | prevalence of frailty and evaluation of associated variables among copd patients |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7297564/ https://www.ncbi.nlm.nih.gov/pubmed/32606644 http://dx.doi.org/10.2147/COPD.S250299 |
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