Frailty transitions and associated clinical outcomes in patients with stable COPD: A longitudinal study

Bernabeu-Mora, Roberto; Oliveira-Sousa, Silvana Loana de; Sánchez-Martínez, Ma Piedad; García-Vidal, José Antonio; Gacto-Sánchez, Mariano; Medina-Mirapeix, Françesc

doi:10.1371/journal.pone.0230116

Cited by 21 publications

(18 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Some works published in the literature have found this association, [5,25,[28][29][30], while other authors have been unable to confirm these findings [19,26,31]. These discrepancies may be because, in reality, in these studies, age acts as a surrogate variable for other more important factors such as the presence of comorbidities or the patient's state of frailty [32]. The relationship between the aging process and the ability to generate a sufficient PIF is complex and should be explored further.…”

Section: Discussionmentioning

confidence: 90%

Evaluation of Suboptimal Peak Inspiratory Flow in Patients with Stable COPD

Represas-Represas

Aballe-Santos

Fernández-García³

et al. 2020

JCM

View full text Add to dashboard Cite

Objective: Although the importance of assessing inspiratory flow in the selection of treatments for chronic obstructive pulmonary disease (COPD) is understood, evaluation of this factor is not yet widespread or standardized. The objective of the present work was to evaluate the peak inspiratory flow (PIF) of patients with COPD and to explore the variables associated with a suboptimal PIF. Methods: An observational, cross-sectional study was carried out at specialized nursing consultations over a period of 6 months. We collected clinical data as well as data on symptoms, treatment adherence, and patient satisfaction with their inhalers via questionnaires. PIF was determined using the In-Check Dial G16® device (Clement Clarke International, Ltd., Harlow, UK). In each case, the PIF was considered suboptimal when it was off-target for any of the prescribed inhalers. The association with suboptimal PIF was evaluated using multivariate logistic regression and the results were expressed as the odds ratio (OR) with 95% confidence interval (CI). Results: A total of 122 COPD patients were included in this study, of whom 34 (27.9%) had suboptimal PIF. A total of 229 inhalers were tested, of which 186 (81.2%) were dry powder devices. The multivariate analysis found an association between suboptimal PIF and age (OR = 1.072; 95% CI (1.019, 1.128); p = 0.007) and forced vital capacity (OR = 0.961; 95% CI (0.933, 0.989); p = 0.006). Conclusions: About a third of patients in complex specialized COPD care have suboptimal PIFs, which is related to age and forced vital capacity.

show abstract

Section: Discussionmentioning

confidence: 90%

Evaluation of Suboptimal Peak Inspiratory Flow in Patients with Stable COPD

Represas-Represas

Aballe-Santos

Fernández-García³

et al. 2020

JCM

View full text Add to dashboard Cite

show abstract

“…The association between frailty and mortality has been well established, 15 based on the fact that COPD and frailty share a common pathogenesis and that co-morbidity is more prevalent in older patients. 30 , 31 The FI-Lab used in this paper is a 23-item indicator (21 hematological indices plus systolic and diastolic blood pressures) that was proposed by Howlett et al 19 , 20 , 32 The FI-Lab has been widely used for objective assessments of the degrees of frailty. FI-Lab values were found to be significantly higher in non-survivors than in survivors.…”

Section: Discussionmentioning

confidence: 99%

A Frailty Assessment Tool to Predict In-Hospital Mortality in Patients with Acute Exacerbations of Chronic Obstructive Pulmonary Disease

Gu¹,

Liu²,

Zheng³

2021

COPD

View full text Add to dashboard Cite

Background The exacerbation of chronic obstructive pulmonary disease (AECOPD) is a chronic, frequent, and life-threatening lung disease. In 2014, a frailty index (FI) based on deficits in commonly used laboratory tests (FI-Lab) was suggested to identify older adults at increased risk of death. Objective We aim to study the prognostic value of the FI-Lab in older Chinese patients who were admitted because of AECOPD. Methods We screened 1932 older patients hospitalized with AECOPD from September 2016 to June 2019 at Zhenjiang First People’s Hospital, China. A multivariate logistic regression analysis was used to identify prognostic factors for in-hospital mortality. Results A total of 77 survivors and 77 non-survivors were finally included in the study. Both the mean DECAF (including dyspnea, eosinopenia, consolidation, acidemia, and atrial fibrillation) score and the mean FI-Lab value of non-survivors were statistically higher than those of survivors (4.45 ± 0.80 versus 3.03 ± 0.90, P =0.000; 0.51 ± 0.13 versus 0.29 ± 0.10, P =0.000, respectively). Logistic regression analysis suggested that DECAF Rank and FI-Lab Rank were strongly related factors of death in AECOPD patients. The areas under the receiver-operating characteristic (ROC) curves were 0.906 for FI-Lab and 0.870 for DECAF ( P =0.2991). Conclusion FI-Lab is a simple, efficient, and objective tool to stratify the risk of in-hospital mortality of AECOPD.

show abstract

“…The association between frailty and mortality has been well established [15]. Based on the fact that COPD and frailty share a common pathogenesis and that co-morbidity is more common in older patients [30,31]. The Frailty Index Based on Laboratory Tests (FI-Lab) used in this paper is a 23-item indicator (21 hematological indices plus systolic and diastolic blood pressure) program proposed by Howlett SE et al [18,19,32].…”

Section: Discussionmentioning

confidence: 99%

A new tool for predicting in-hospital mortality in Chinese older patients with exacerbation of chronic obstructive pulmonary disease(AECOPD): frailty index based on common laboratory tests (FI-Lab)

Gu¹,

Zheng²,

Liu³

2020

Preprint

View full text Add to dashboard Cite

Introduction: The exacerbation of chronic obstructive pulmonary disease(AECOPD)is a common and fetal disease but with no ideal predictor of in-hospital mortality. Frailty prevails in older adults with AECOPD and can cause increased vulnerability to many adverse health outcomes including death. However, we know little about how frailty affects in-hospital mortality in older AECOPD patients. Objective: To explore the predictive validity of FI-Lab—an objective tool for assessing frailty including 21 routine blood tests plus systolic and diastolic blood pressure (a score between 0 and 1, a higher score indicates greater frailty)—for in-hospital mortality in patients with AECOPD. Methods: We reviewed the hospitalization records of older AECOPD inpatients from September 2016 to June 2019 at Zhenjiang First People's Hospital. We compared survivors to non-survivors. We used propensity score matching (PSM) to balance priori differences between survivors and non-survivors. Logistic regression analysis was used to select the associated predictors of in-hospital mortality. Receiver-operating characteristic (ROC) curves were calculated to estimate the area under the ROC curve (AUCs) for FI-Lab and DECAF(a commonly used predictor of AECOPD including dyspnea, eosinophilia, pulmonary consolidation, acidemia, and atrial fibrillation; a score between 1and 6; a higher score indicates poorer condition)in relation to mortality. Data were analyzed using IBM SPSS for Windows, Version 23.0. Results: A total of 154 patients—77 survivors and 77 non-survivors—were included in the study finally. The mean age of these patients was 79.73 ± 8.38 years. Both of the mean DECAF score, the mean FI-Lab value of non-survivors were statistically higher than those of survivors(4.45 ± 0.80 versus 3.03 ± 0.90,P = 0.000; 0.51 ± 0.13 versus 0.29 ± 0.10,P = 0.000,respectively). Logistic regression analysis suggested that high DECAF grade and high FI-Lab grade were strong related factors of death in AECOPD patients (OR:5.620, 95%CI 2.811–11.236, P = 0.000; OR:8.705, 95%CI 3.646–20.782, P = 0.000, respectively). The DECAF scores of most non-survivors were ≥ 4༈n = 71,92.21%༉. FI-Lab value predicted in-hospital mortality at a cut-off value of 0.4388 with 70.1% sensitivity, 96.1% specificity, 0.675 Youden index. DECAF score predicted in-hospital mortality at a cut-off value of 3.5 with 92.2% sensitivity, 72.7% specificity, 0.649 Youden index. The areas under the ROC curves were 0.906 for FI-Lab and 0.870 for DECAF with no statistically significant༈P = 0.2991). Conclusions: FI-Lab has a slightly stronger screening ability than DECAF. FI-Lab is a simple, effective and objective indicator and can be quick to help clinicians to assess in-hospital mortality of AECOPD patients.

show abstract

Frailty transitions and associated clinical outcomes in patients with stable COPD: A longitudinal study

Cited by 21 publications

References 29 publications

Evaluation of Suboptimal Peak Inspiratory Flow in Patients with Stable COPD

Evaluation of Suboptimal Peak Inspiratory Flow in Patients with Stable COPD

A Frailty Assessment Tool to Predict In-Hospital Mortality in Patients with Acute Exacerbations of Chronic Obstructive Pulmonary Disease

A new tool for predicting in-hospital mortality in Chinese older patients with exacerbation of chronic obstructive pulmonary disease(AECOPD): frailty index based on common laboratory tests (FI-Lab)

Contact Info

Product

Resources

About