Extra-pulmonary features in COPD patients entering rehabilitation after stratification for MRC dyspnea grade

M.A. Spruit, H.J. Pennings, P.P. Janssen, J.D. Does, S. Scroyen, M.A. Akkermans, R. Mostert, E.F. Wouters

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Experts have stated that referral for rehabilitation of patients with chronic obstructive pulmonary disease (COPD) becomes appropriate when these patients become aware of their disability (e.g. usually grade 3 to 5 on the Medical Research Council (MRC) dyspnea scale). However, patients with MRC dyspnea grade 1/2 may also suffer from extra-pulmonary features, such as abnormal body composition, exercise intolerance and reduced disease-specific health status. In the present study, we have studied whether and to what extent chronic obstructive pulmonary disease (COPD) patients with MRC dyspnea grade 1/2 have extra-pulmonary features compared to patients with grade 3, 4 or 5? Pulmonary function, body composition, 6-min walking distance, peak exercise capacity, anxiety, depression and disease-specific health status have been assessed in 333 outpatients who had been referred for pulmonary rehabilitation. On average, patients with MRC dyspnea grade 1/2 had a better exercise tolerance and disease-specific health status compared to patients with grade 4 or 5. Nevertheless, grade 1/2 patients had a higher prevalence of muscle mass depletion. In addition, these patients did still have aberrant values in one or more of the aforementioned outcomes. On average, patients with MRC dyspnea grade 1/2 may clearly suffer from extra-pulmonary features, indicating the necessity to refer these patients for rehabilitation. Therefore, MRC dyspnea scale alone does not appear to be a suitable measure to identify most patients with COPD who have to be referred for rehabilitation. AD - Department of Research, Development & Education, Centre for Integrated Rehabilitation of Organ failure (CIRO), Horn, The Netherlands. AU - Spruit MA AU - Pennings HJ AU - Janssen PP AU - Does JD AU - Scroyen S AU - Akkermans MA AU - Mostert R AU - Wouters EF LA - ENG PT - JOURNAL ARTICLE DEP - 20070830 TA - Respir Med JID - 8908438
Original languageEnglish
Pages (from-to)2454-2463
JournalRespiratory Medicine
Issue number12
Publication statusPublished - 1 Jan 2007

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