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Exacerbations, Hospital Admissions and Impaired Health Status in Chronic Obstructive Pulmonary Disease

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Abstract

Impaired health status may be a risk factor for frequent exacerbations and hospital admission and, in turn, exacerbations and admissions may further impair the health status of patients with COPD. We have investigated the variables associated with frequent exacerbations (3 or more per year) and admission, with particular interest in health status, in a cohort of ambulatory patients with moderate to severe COPD attended by chest physicians in Spain. A total of 227 investigators included 1057 patients with a mean predicted FEV1 of 41.8%. The mean total score on the St. George’s Respiratory Questionnaire (SGRQ) was 47.9 units, and 300 patients (28.4%) had 3 or more exacerbations the previous year and 344 (32.6%) were admitted at least once during the same period. In multivariate analysis only the SGRQ total score was significantly associated with both frequent exacerbations (OR = 1.04; 95% CI = 1.01–2.12; p<0.0001) and admission (OR = 1.01; 95% CI = 1.00–1.02; p = 0.0008). Other variables significantly associated with frequent exacerbations were chronic mucus hypersecretion, increased baseline dyspnea, comorbidity, GOLD stage IV and treatment with inhaled corticosteroids. Variables associated with admission were lower educational level, increased number of exacerbations, use of long-term oxygen therapy and use of short acting beta-2 agonists. An impaired health status is associated with an increased number of exacerbations and with admission to hospital in the previous year. These results, together with previous studies, confirm that impairment in health status in COPD is both a marker of risk for, and a consequence of, frequent exacerbations and admissions.

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Authors and Affiliations

  1. Servei de Pneumologia, Institut Clínic del Tòrax (IDIBAPS), Red Respira RTIC 03/11 ISCIII, Hospital Clinic, Villarroel 170 (UVIR, esc 2, planta 3), 08036, Barcelona, Spain

    Marc Miravitlles

  2. Servicio de Neumología, Red Respira RTIC 03/11 ISCIII. Hospital Clínico San Carlos, Madrid, Spain

    Miriam Calle

  3. Servicio de Neumología, Red Respira RTIC 03/11 ISCIII. Hospital Virgen del Rocío, Sevilla, Spain

    Francisco Alvarez-Gutierrez

  4. R&D Department, Boehringer Ingelheim, Barcelona, Spain

    Elena Gobartt

  5. Francisco López, Nufarm 21, Madrid, Spain

    Francisco López

  6. R&D Department Pfizer, Madrid, Spain

    Antonio Martín

Authors
  1. Marc Miravitlles
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  2. Miriam Calle
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  3. Francisco Alvarez-Gutierrez
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  4. Elena Gobartt
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  5. Francisco López
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  6. Antonio Martín
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Corresponding author

Correspondence to Marc Miravitlles.

Additional information

The EIME study group Sources of funding: National Science Council (NSC 92-2314-B-010-048).

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Miravitlles, M., Calle, M., Alvarez-Gutierrez, F. et al. Exacerbations, Hospital Admissions and Impaired Health Status in Chronic Obstructive Pulmonary Disease. Qual Life Res 15, 471–480 (2006). https://doi.org/10.1007/s11136-005-3215-y

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  • DOI: https://doi.org/10.1007/s11136-005-3215-y

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