The relationship between body mass index and health-related quality of life in COPD: real-world evidence based on claims and survey data

Huber, Manuel B.; Kurz, Christoph; Kirsch, F.W.; Schwarzkopf, Larissa; Schramm, Anja; Leidl, Reiner

doi:10.1186/s12931-020-01556-0

Cited by 17 publications

(18 citation statements)

References 49 publications

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“…A residual chronic or recurrent inflammation that affects the lung compliance, leading to obstruction of airway, narrowing of bronchiolar system, leads to accelerated emphysematous and peribronchial fibrosis. 7,8 A positive correlation with age, BMI, and duration of symptoms was found in this study similar to the findings of Huber et al 9 Among the patients studied having history of hospitalization, a significant difference was observed between the status of smokers and non-smokers among COPD patients, which was similar to the results obtained by Ramakrishna et al, however, among never smokers, our study could not find and evaluate sufficient data matrix for associating it with tuberculosis in the development of COPD. 10 This can also be partly because of the fact that we studied patients who had enrolled for hospitalization with the symptoms of COPD, there were more chances of them having previous history of TB.…”

Section: Discussionsupporting

confidence: 91%

Evaluation of tuberculosis associated chronic pulmonary disease at community health care: a case control study

Sharma¹,

Badyal

2021

Int J Community Med Public Health

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Background: Chronic obstructive pulmonary disease (COPD) is known to occur in patients with previous history of pulmonary TB. It is still not very well known if there is any difference of clinical presentation between smoking related COPD or/and TB associated COPD. Methods: The present case control study was conducted at CHC Katra, Department of Medicine, over a period of 6 months from August 2018 to February 2018, on 100 patients; 50 suffering from COPD and 50 healthy individuals. Detailed clinical history for duration of symptoms, previous hospitalizations, and exposure to smoking along with the history of TB and ATT courses was recorded.Results: History of TB was found in 17 patients among cases and 7 patients among controls. In TB associated COPD, the pack years of smoking in case of smokers was 22.4±19.2. 44% (15/34) having exposure to smoking had history of TB. Mean age of patients exposed to smoking was (53.3±7.4) and that of non-smokers (60.1±8.2). A positive correlation with age, BMI, and duration of symptoms was found. Our results showed that almost one-third of COPD patients (34%) had history of TB. TB-associated COPD patients had similar symptoms in our study except for high frequency of hemoptysis.Conclusions: A detailed population survey is needed on COPD patients with history of TB. A larger group study among never-smokers is also needed. Finally, it is concluded that the case burden of TB associated COPD is real, huge and an urgent policy decision in this regard is mandated.

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Section: Discussionsupporting

confidence: 91%

Evaluation of tuberculosis associated chronic pulmonary disease at community health care: a case control study

Sharma¹,

Badyal

2021

Int J Community Med Public Health

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“…However, significant differences between both groups existed for several unmatched variables, including generic and disease-specific HRQoL. VAS and all descriptive dimensions of the EQ-5D-5L except pain/discomfort differed, while half of the CAT dimensions [ 4 – 6 , 8 ], especially those affecting activity and energy levels, differed significantly as well. There was no significant difference in central indictors of disease severity such as FEV 1 predicted or number of severe exacerbations.…”

Section: Resultsmentioning

confidence: 89%

“…Data were retrieved for all patients who participated in the COPD disease management program (DMP), a structured treatment/surveillance program for COPD patients. More information about the data can be found elsewhere [ 8 ]. Overall, the survey was sent to 49,664 DMP patients, 14,753 (29.7%) of whom responded.…”

Section: Methodsmentioning

confidence: 99%

“…Furthermore, among over 400 prognostic COPD models for hard clinical outcomes, BMI is the fourth most frequently used predictor following age, FEV 1 , and sex [ 6 ]. In cross-sectional perspective, high BMI is associated with reduced HRQoL in COPD [ 7 , 8 ]; regarding development over time, evidence is rare and not specific [ 9 ], indicating a research gap.…”

Section: Introductionmentioning

confidence: 99%

“…Taken together, BMI gain represents a fundamental aspect of disease management in COPD that has the potential to improve patient health perception, when specific criteria are met. Going beyond a previous study that evaluated the effect of absolute BMI values on health perception in COPD in a cross-sectional setting [ 8 ], the aim of this study is to evaluate the association between BMI development and HRQoL in a longitudinal context.…”

Section: Introductionmentioning

confidence: 99%

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Long-term weight gain in obese COPD patients participating in a disease management program: a risk factor for reduced health-related quality of life

et al. 2021

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Background Little is known about how long-term weight gain affects the health perception of COPD patients. Objectives The aim is to evaluate the long-term association of BMI change and health-related quality of life (HRQoL) in obese COPD patients. Methods Claims and survey data from a COPD disease management program were used to match two groups of COPD patients with BMI ≥ 30 who have differing weight trajectories over a 5-year timespan via propensity score and genetic matching. EQ-5D-5L, including visual analog scale (VAS) and COPD Assessment Test (CAT), were used as outcomes of interest. Sociodemographic and disease-based variables were matched. Results Out of 1202 obese COPD patients, 126 with a weight increase of four or more BMI points were matched separately with 252 (propensity score matching) and 197 (genetic matching) control subjects who had relatively stable BMI. For the EQ-5D-5L, patients with BMI increase reported significantly worse health perception for VAS and all descriptive dimensions except pain/discomfort. For the CAT, especially the perception of ability to complete daily activities and overall energy results were significantly worse. VAS differences reach the range of minimal important differences. Stopping smoking and already being in obesity class II were the most influential risk factors for BMI increase. Conclusion Obese COPD patients who gain four or more BMI points over 5 years report significantly lower results in different dimensions of generic and disease-specific HRQoL than their peers with stable BMI. To improve real-world outcomes, tracking and preventing specific BMI trajectories could constitute a clinically relevant aspect of managing COPD patients.

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Undernutrition is associated with mortality, exacerbation, and poorer quality of life in patients with chronic obstructive pulmonary disease: A systematic review with meta‐analysis of observational studies

Pereira

Lima

Silva

2022

J Parenter Enteral Nutr

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Impaired nutrition status is recognized as a risk factor for worse clinical outcomes in patients with chronic obstructive pulmonary disease (COPD). The aims of this study were to investigate how undernutrition is diagnosed, its prevalence, and whether there is an association between this condition and clinical outcomes in patients with COPD.The search for this systematic review of observational studies (PROSPERO: CRD42020191888) was performed in the PubMed, Embase, and Scopus databases, with no date or language restrictions. The studies had to report data on the diagnosis of undernutrition and its association with mortality, exacerbation, length of hospital stay, or quality of life in adult patients with COPD. A meta-analysis with a random-effects model was performed to combine data. Forty-nine studies were included (20 of them classified as having a low risk of bias), and the most common diagnostic method of undernutrition was body mass index (BMI) (n = 36). The pooled prevalence of undernutrition was equal to 20% (95% CI, 0.15-0.25; I² = 100%), and it was associated with mortality (risk ratio = 1.97; 95% CI, 1.55-2.50; I² = 98%), exacerbation (risk ratio = 1.73; 95% CI, 1.03-2.91; I² = 96%), and poorer quality of life (mean difference = 8.25; 95% CI,; I² = 79%). For all outcomes, the certainty of evidence was very low.In conclusion, undernutrition is prevalent and is associated with poorer outcomes in patients with COPD. However, undernutrition is mainly diagnosed by BMI, which underreports its prevalence, and the certainty of the evidence is very low.

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The relationship between body mass index and health-related quality of life in COPD: real-world evidence based on claims and survey data

Cited by 17 publications

References 49 publications

Evaluation of tuberculosis associated chronic pulmonary disease at community health care: a case control study

Evaluation of tuberculosis associated chronic pulmonary disease at community health care: a case control study

Long-term weight gain in obese COPD patients participating in a disease management program: a risk factor for reduced health-related quality of life

Undernutrition is associated with mortality, exacerbation, and poorer quality of life in patients with chronic obstructive pulmonary disease: A systematic review with meta‐analysis of observational studies

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