The influence of hospitalizations due to exacerbations or spontaneous pneumothoraxes on the quality of life, mental function and symptoms of depression and anxiety in patients with COPD or asthma

Filipowski, M; Bożek, Andrzej; Kozłowska, Renata; Czyżewski, Damian; Jarząb, Jerzy

doi:10.3109/02770903.2013.862543

Cited by 16 publications

(9 citation statements)

References 22 publications

(38 reference statements)

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“…By contrast, no differences in AQLQ scores were observed between these subgroups of patients suggesting that the AQLQ may not be sufficiently discriminating for assessing HRQoL in patients with SA and exacerbations. Indeed, it has been suggested that standard asthma questionnaires, such as AQLQ, may not detect symptom changes in SA as well as the SGRQ, which has been widely used in severe respiratory diseases such as COPD and has a broader focus (28)(29)(30)(31)(32)(33)(34). Together, this information should be considered in the design of similar studies of severe asthma in the future.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and burden of illness among adolescent and adult patients with severe asthma by asthma control: the IDEAL study

Müllerová¹,

Cockle

Gunsoy

et al. 2020

Journal of Asthma

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Objectives: Severe asthma (SA) can be uncontrolled despite guideline-directed treatment. We described SA characteristics and identified factors associated with uncontrolled disease and frequent exacerbations. Methods: Post hoc analysis of the observational IDEAL study (201722/NCT02293265) included patients with SA aged !12 years receiving high-dose inhaled corticosteroids plus additional controller(s) for !12 months. Uncontrolled SA was defined by Asthma Control Questionnaire (ACQ)-5 scores !1.5 or !1 exacerbations (prior year), and further stratified by exacerbation frequency (no/infrequent [0-1] vs frequent [!2]; prior year); associated factors were determined using multivariate logistic regression. Results: Of 670 patients with SA, 540 (81%) were uncontrolled (ACQ-5 scores !1.5: 80%; !1 exacerbations [prior year]: 71%). Uncontrolled patients had lower lung function and worse health-related quality of life (HRQoL) than controlled patients; 197/540 (37%) experienced frequent exacerbations (prior year). Worse St George's Respiratory Questionnaire (SGRQ) total score, comorbid sinusitis, or eczema were significantly associated with uncontrolled SA; younger age, never smoker status, exacerbation requiring hospitalization (previous year), worse SGRQ symptom score, comorbid nasal polyps, COPD, or osteoporosis were significantly associated with uncontrolled SA with frequent exacerbations. Conclusions: In IDEAL, one-fifth of patients with SA were controlled, based on symptoms. Uncontrolled, exacerbating SA was associated with specific comorbidities, frequent exacerbations, a lower lung function, and compromised HRQoL, although inference from this analysis is limited by the selective cross-sectional nature of the cohort. Nonetheless, these data highlight the need for more effective precision treatments in this population.

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Section: Discussionmentioning

confidence: 99%

Clinical characteristics and burden of illness among adolescent and adult patients with severe asthma by asthma control: the IDEAL study

Müllerová¹,

Cockle

Gunsoy

et al. 2020

Journal of Asthma

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“…Although data concerning the readmission rate were very limited, in a study by Almagro et al, patients with acute exacerbation of COPD showed readmission rates of 38.5% and 58.5% at the 90-day and 1-yr follow ups, respectively ( 22 ). However, hospitalizations in patients with chronic lung disease are usually associated with a long hospital stay, high complication rate, and high hospital cost ( 23 , 24 , 25 , 26 ). Therefore, physicians should attempt to decrease the rate of hospital admissions of patients with chronic respiratory insufficiency through thorough patient monitoring and effective treatments.…”

Section: Discussionmentioning

confidence: 99%

One-year Prognosis and the Role of Brain Natriuretic Peptide Levels in Patients with Chronic Cor Pulmonale

et al. 2015

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Data on the clinical outcomes and role of brain natriuretic peptide (BNP) levels in patients with chronic cor pulmonale are limited. A total of 69 patients with chronic cor pulmonale, admitted for dyspnea (January 2007 to September 2011) to three university hospitals, were retrospectively reviewed. All of the patients had right ventricular (RV) dysfunction on echocardiography. The median age was 70.0 yr, and chronic obstructive pulmonary disease (40.6%) and tuberculosis-destroyed lung (TDL, 27.5%) were the leading causes of chronic cor pulmonale. At the 1-yr follow-up, the mortality rate was 15.9%, and the readmission rate was 53.7%; patients with TDL had higher mortality (31.6% vs. 10.0%; P=0.059) and readmission rates (78.9% vs. 43.8%; P=0.009) than those with non-TDL diseases. The area under the receiver operating characteristic curve for admission BNP levels to predict readmission was 0.788 (95% confidence interval [CI], 0.673-0.904), and the sensitivity and specificity of the cut-off value were 80.6% and 77.4%, respectively. In multivariate analysis, high admission BNP levels were a significant risk factor for subsequent readmission (hazard ratio, 1.049; 95% CI, 1.005-1.094). Additionally, admission BNP levels were well correlated with cardiac troponin I (r=0.558), and delta BNP also correlated with delta RV systolic pressure (n=25; r=0.562). In conclusion, among hospitalized patients with chronic cor pulmonale, admission high BNP levels are a significant risk factor for subsequent readmission. Therefore, more intensive monitoring and treatment are needed in patients with higher BNP levels.Graphical Abstract

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“…30 Filipowski et al similarly demonstrated significant decreases in mini mental status exam scores following a COPD exacerbation or spontaneous pneumothorax. 31 The prevalence of cognitive impairment in COPD has been reported to be between 3 and 20%, and varies based on the population and diagnostic criteria used. 28 A few studies have attempted to better understand possible mechanisms for the findings of increased risk for cognitive dysfunction in individuals with COPD.…”

Section: Overlap Of Specific Comorbidities and Chronic Obstructive Pumentioning

confidence: 99%

Comorbidities and Chronic Obstructive Pulmonary Disease: Prevalence, Influence on Outcomes, and Management

Putcha

Drummond

Wise

et al. 2015

Semin Respir Crit Care Med

137

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Comorbidities impact a large proportion of patients with chronic obstructive pulmonary disease (COPD), with over 80% of patients with COPD estimated to have at least one comorbid chronic condition. Guidelines for the treatment of COPD are just now incorporating comorbidities to their management recommendations of COPD, and it is becoming increasingly clear that multimorbidity as well as specific comorbidities have strong associations with mortality and clinical outcomes in COPD, including dyspnea, exercise capacity, quality of life, healthcare utilization, and exacerbation risk. Appropriately, there has been an increased focus upon describing the burden of comorbidity in the COPD population and incorporating this information into existing efforts to better understand the clinical and phenotypic heterogeneity of this group. In this article, we summarize existing knowledge about comorbidity burden and specific comorbidities in COPD, focusing on prevalence estimates, association with outcomes, and existing knowledge about treatment strategies.

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The influence of hospitalizations due to exacerbations or spontaneous pneumothoraxes on the quality of life, mental function and symptoms of depression and anxiety in patients with COPD or asthma

Abstract: Low QoL and mental impairment were observed in patients with asthma and COPD. In addition, the QoL significantly decreased following hospitalizations due to exacerbations or SP.

Cited by 16 publications

References 22 publications

Clinical characteristics and burden of illness among adolescent and adult patients with severe asthma by asthma control: the IDEAL study

Clinical characteristics and burden of illness among adolescent and adult patients with severe asthma by asthma control: the IDEAL study

One-year Prognosis and the Role of Brain Natriuretic Peptide Levels in Patients with Chronic Cor Pulmonale

Comorbidities and Chronic Obstructive Pulmonary Disease: Prevalence, Influence on Outcomes, and Management

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