TY - JOUR
T1 - Physical status, symptoms and health-related quality of life during a severe exacerbation of COPD
T2 - Recovery and discriminative capacity for future events
AU - Quadflieg, Kirsten
AU - Machado, Ana
AU - de Lima, Fabiano Francisco
AU - Dederen, Anand
AU - Daenen, Marc
AU - Ruttens, David
AU - Thomeer, Michiel
AU - Spruit, Martijn A.
AU - Burtin, Chris
N1 - Funding Information:
Ana Machado's work was supported by Bijzonder Onderzoeksfonds – Bilaterale Samenwerking (BOF BILA) from Hasselt University (BOF BILA reference: DOC/SCHL-BOSE/190/522 ). Fabiano Francisco de Lima's work was supported by the São Paulo Research Foundation – FAPESP (Grant: 2019/10744–3 ). The authors report no involvement in the research by the sponsor that could have influenced the outcome of this work.
Publisher Copyright:
© 2023 Elsevier Ltd
PY - 2023/12/1
Y1 - 2023/12/1
N2 - Objective: Severe acute exacerbations of chronic obstructive pulmonary disease (AECOPD) can have a negative impact on functional capacity, symptoms and health-related quality of life (HRQOL). This study aimed to i) investigate the recovery of muscle strength, functional capacity, symptoms, and HRQOL in patients after a severe AECOPD; ii) compare with matched patients with stable COPD (SCOPD); and iii) assess whether these assessments at hospital discharge could discriminate patients’ risk for future events. Methods: This observational study assessed patients with AECOPD during hospital discharge (T1) and one month after discharge (T2). Patients with SCOPD were assessed once. Quadriceps force, handgrip strength, short physical performance battery (SPPB), 6-min walk distance (6 MWD), COPD assessment test (CAT), London chest activity of daily living (LCADL), modified medical research council, checklist individual strength-fatigue, patient health questionnaire, and physical activity (Actigraph) were measured. Exacerbation-related readmission and mortality within six months and 1-year were collected. Results: Forty-four patients with AECOPD were matched with 44 patients with SCOPD. At T2, a significant improvement was found for the SPPB total score, 6 MWD, CAT score, and LCADL score. Compared to patients with SCOPD, a worse LCADL score was found at T2 in patients with AECOPD. Patients with AECOPD that were readmitted or died had a worse SPPB classification and five-repetition sit-to-stand test at T1. Conclusion: Patients after severe AECOPD improved in functional capacity and HRQOL one month after hospital discharge, but ADL performance was still worse compared to SCOPD. Patients who were readmitted or died had significantly worse scores on functional tests at hospital discharge.
AB - Objective: Severe acute exacerbations of chronic obstructive pulmonary disease (AECOPD) can have a negative impact on functional capacity, symptoms and health-related quality of life (HRQOL). This study aimed to i) investigate the recovery of muscle strength, functional capacity, symptoms, and HRQOL in patients after a severe AECOPD; ii) compare with matched patients with stable COPD (SCOPD); and iii) assess whether these assessments at hospital discharge could discriminate patients’ risk for future events. Methods: This observational study assessed patients with AECOPD during hospital discharge (T1) and one month after discharge (T2). Patients with SCOPD were assessed once. Quadriceps force, handgrip strength, short physical performance battery (SPPB), 6-min walk distance (6 MWD), COPD assessment test (CAT), London chest activity of daily living (LCADL), modified medical research council, checklist individual strength-fatigue, patient health questionnaire, and physical activity (Actigraph) were measured. Exacerbation-related readmission and mortality within six months and 1-year were collected. Results: Forty-four patients with AECOPD were matched with 44 patients with SCOPD. At T2, a significant improvement was found for the SPPB total score, 6 MWD, CAT score, and LCADL score. Compared to patients with SCOPD, a worse LCADL score was found at T2 in patients with AECOPD. Patients with AECOPD that were readmitted or died had a worse SPPB classification and five-repetition sit-to-stand test at T1. Conclusion: Patients after severe AECOPD improved in functional capacity and HRQOL one month after hospital discharge, but ADL performance was still worse compared to SCOPD. Patients who were readmitted or died had significantly worse scores on functional tests at hospital discharge.
KW - COPD
KW - Exacerbation
KW - Hospitalization
KW - Mortality
KW - Readmission
U2 - 10.1016/j.rmed.2023.107437
DO - 10.1016/j.rmed.2023.107437
M3 - Article
SN - 0954-6111
VL - 220
JO - Respiratory Medicine
JF - Respiratory Medicine
IS - 1
M1 - 107437
ER -