The Association of Depressive Symptoms With Rates of Acute Exacerbations in Patients With COPD: Results From a 3-year Longitudinal Follow-up of the ECLIPSE Cohort

Abebaw Mengistu Yohannes; Hana Mulerova; Kim Lavoie; Jorgen Vestbo; Steve I. Rennard; Emile Wouters; Nicola A. Hanania

doi:10.1016/j.jamda.2017.05.024

The Association of Depressive Symptoms With Rates of Acute Exacerbations in Patients With COPD: Results From a 3-year Longitudinal Follow-up of the ECLIPSE Cohort

Abebaw Mengistu Yohannes^*, Hana Mulerova, Kim Lavoie, Jorgen Vestbo, Steve I. Rennard, Emile Wouters, Nicola A. Hanania

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background: Depression increases disability and health care utilization in older patients with chronic obstructive pulmonary disease (COPD).

Objectives: To determine contribution of depressive symptoms to the incidence of moderate-severe and severe acute exacerbations of COPD (AECOPD) over 3 years.

Design: We analyzed data collected from a prospective cohort of patients with COPD (Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints; ECLIPSE).

Setting: Multicentered outpatient.

Participants: A total of 2059 patients with COPD with complete data (63.7% men, mean age 63.4 + 7.1 years).

Measurements: Depression was assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). Moderate-severe AECOPDs were collected; a subset of very severe AECOPD was defined as requiring hospital admission.

Results: A total of 540 (26%) patients with COPD reported high depressive symptoms (CES-D >= 16). High depressive symptoms at baseline related to an increased risk of moderate-severe and severe AECOPD during the follow-up (odds ratio [OR] 1.18; 95% confidence interval [CI] 1.07-1.30; for moderate-severe and OR 1.36; 95% CI 1.09-1.69 for severe events risk of hospitalizations) independent of key covariates of an AECOPD history before recruitment in the study, history of gastroesophageal reflux, baseline severity of airflow limitation, and white blood cell count that were also associated with an increased risk of moderate to severe exacerbations (all P <.001).

Conclusion: Presence of high depressive symptoms at baseline were associated with subsequent moderate-severe exacerbations and hospital admissions in patients with COPD over 3 years, independent of a history of exacerbations and other demographic and clinical factors. Targeted personalized medicinethat focuses both on AECOPD risk and depression may be a step forward to improving prognosis of patients with COPD. (C) 2017 AMDA - The Society for Post-Acute and Long-Term Care Medicine.

Original language	English
Pages (from-to)	955-959
Number of pages	11
Journal	Journal of the American Medical Directors Association
Volume	18
Issue number	11
DOIs	https://doi.org/10.1016/j.jamda.2017.05.024
Publication status	Published - Nov 2017

Keywords

COPD
depression
longitudinal study
acute exacerbations
AECOPD
hospitalization
previous history of exacerbation
OBSTRUCTIVE PULMONARY-DISEASE
SYSTEMIC INFLAMMATION
ANXIETY
IMPACT
RISK
QUESTIONNAIRE
READMISSION
MORTALITY

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10.1016/j.jamda.2017.05.024

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Yohannes, A. M., Mulerova, H., Lavoie, K., Vestbo, J., Rennard, S. I., Wouters, E., & Hanania, N. A. (2017). The Association of Depressive Symptoms With Rates of Acute Exacerbations in Patients With COPD: Results From a 3-year Longitudinal Follow-up of the ECLIPSE Cohort. Journal of the American Medical Directors Association, 18(11), 955-959. https://doi.org/10.1016/j.jamda.2017.05.024

@article{d2819ca2a93741788565c1c848b9a1bc,

title = "The Association of Depressive Symptoms With Rates of Acute Exacerbations in Patients With COPD: Results From a 3-year Longitudinal Follow-up of the ECLIPSE Cohort",

abstract = "Background: Depression increases disability and health care utilization in older patients with chronic obstructive pulmonary disease (COPD).Objectives: To determine contribution of depressive symptoms to the incidence of moderate-severe and severe acute exacerbations of COPD (AECOPD) over 3 years.Design: We analyzed data collected from a prospective cohort of patients with COPD (Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints; ECLIPSE).Setting: Multicentered outpatient.Participants: A total of 2059 patients with COPD with complete data (63.7% men, mean age 63.4 + 7.1 years).Measurements: Depression was assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). Moderate-severe AECOPDs were collected; a subset of very severe AECOPD was defined as requiring hospital admission.Results: A total of 540 (26%) patients with COPD reported high depressive symptoms (CES-D >= 16). High depressive symptoms at baseline related to an increased risk of moderate-severe and severe AECOPD during the follow-up (odds ratio [OR] 1.18; 95% confidence interval [CI] 1.07-1.30; for moderate-severe and OR 1.36; 95% CI 1.09-1.69 for severe events risk of hospitalizations) independent of key covariates of an AECOPD history before recruitment in the study, history of gastroesophageal reflux, baseline severity of airflow limitation, and white blood cell count that were also associated with an increased risk of moderate to severe exacerbations (all P <.001).Conclusion: Presence of high depressive symptoms at baseline were associated with subsequent moderate-severe exacerbations and hospital admissions in patients with COPD over 3 years, independent of a history of exacerbations and other demographic and clinical factors. Targeted personalized medicinethat focuses both on AECOPD risk and depression may be a step forward to improving prognosis of patients with COPD. (C) 2017 AMDA - The Society for Post-Acute and Long-Term Care Medicine.",

keywords = "COPD, depression, longitudinal study, acute exacerbations, AECOPD, hospitalization, previous history of exacerbation, OBSTRUCTIVE PULMONARY-DISEASE, SYSTEMIC INFLAMMATION, ANXIETY, IMPACT, RISK, QUESTIONNAIRE, READMISSION, MORTALITY",

author = "Yohannes, {Abebaw Mengistu} and Hana Mulerova and Kim Lavoie and Jorgen Vestbo and Rennard, {Steve I.} and Emile Wouters and Hanania, {Nicola A.}",

year = "2017",

month = nov,

doi = "10.1016/j.jamda.2017.05.024",

language = "English",

volume = "18",

pages = "955--959",

journal = "Journal of the American Medical Directors Association",

issn = "1525-8610",

publisher = "Elsevier Inc.",

number = "11",

}

Yohannes, AM, Mulerova, H, Lavoie, K, Vestbo, J, Rennard, SI, Wouters, E & Hanania, NA 2017, 'The Association of Depressive Symptoms With Rates of Acute Exacerbations in Patients With COPD: Results From a 3-year Longitudinal Follow-up of the ECLIPSE Cohort', Journal of the American Medical Directors Association, vol. 18, no. 11, pp. 955-959. https://doi.org/10.1016/j.jamda.2017.05.024

The Association of Depressive Symptoms With Rates of Acute Exacerbations in Patients With COPD: Results From a 3-year Longitudinal Follow-up of the ECLIPSE Cohort. / Yohannes, Abebaw Mengistu; Mulerova, Hana; Lavoie, Kim et al.
In: Journal of the American Medical Directors Association, Vol. 18, No. 11, 11.2017, p. 955-959.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - The Association of Depressive Symptoms With Rates of Acute Exacerbations in Patients With COPD

T2 - Results From a 3-year Longitudinal Follow-up of the ECLIPSE Cohort

AU - Yohannes, Abebaw Mengistu

AU - Mulerova, Hana

AU - Lavoie, Kim

AU - Vestbo, Jorgen

AU - Rennard, Steve I.

AU - Wouters, Emile

AU - Hanania, Nicola A.

PY - 2017/11

Y1 - 2017/11

N2 - Background: Depression increases disability and health care utilization in older patients with chronic obstructive pulmonary disease (COPD).Objectives: To determine contribution of depressive symptoms to the incidence of moderate-severe and severe acute exacerbations of COPD (AECOPD) over 3 years.Design: We analyzed data collected from a prospective cohort of patients with COPD (Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints; ECLIPSE).Setting: Multicentered outpatient.Participants: A total of 2059 patients with COPD with complete data (63.7% men, mean age 63.4 + 7.1 years).Measurements: Depression was assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). Moderate-severe AECOPDs were collected; a subset of very severe AECOPD was defined as requiring hospital admission.Results: A total of 540 (26%) patients with COPD reported high depressive symptoms (CES-D >= 16). High depressive symptoms at baseline related to an increased risk of moderate-severe and severe AECOPD during the follow-up (odds ratio [OR] 1.18; 95% confidence interval [CI] 1.07-1.30; for moderate-severe and OR 1.36; 95% CI 1.09-1.69 for severe events risk of hospitalizations) independent of key covariates of an AECOPD history before recruitment in the study, history of gastroesophageal reflux, baseline severity of airflow limitation, and white blood cell count that were also associated with an increased risk of moderate to severe exacerbations (all P <.001).Conclusion: Presence of high depressive symptoms at baseline were associated with subsequent moderate-severe exacerbations and hospital admissions in patients with COPD over 3 years, independent of a history of exacerbations and other demographic and clinical factors. Targeted personalized medicinethat focuses both on AECOPD risk and depression may be a step forward to improving prognosis of patients with COPD. (C) 2017 AMDA - The Society for Post-Acute and Long-Term Care Medicine.

AB - Background: Depression increases disability and health care utilization in older patients with chronic obstructive pulmonary disease (COPD).Objectives: To determine contribution of depressive symptoms to the incidence of moderate-severe and severe acute exacerbations of COPD (AECOPD) over 3 years.Design: We analyzed data collected from a prospective cohort of patients with COPD (Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints; ECLIPSE).Setting: Multicentered outpatient.Participants: A total of 2059 patients with COPD with complete data (63.7% men, mean age 63.4 + 7.1 years).Measurements: Depression was assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). Moderate-severe AECOPDs were collected; a subset of very severe AECOPD was defined as requiring hospital admission.Results: A total of 540 (26%) patients with COPD reported high depressive symptoms (CES-D >= 16). High depressive symptoms at baseline related to an increased risk of moderate-severe and severe AECOPD during the follow-up (odds ratio [OR] 1.18; 95% confidence interval [CI] 1.07-1.30; for moderate-severe and OR 1.36; 95% CI 1.09-1.69 for severe events risk of hospitalizations) independent of key covariates of an AECOPD history before recruitment in the study, history of gastroesophageal reflux, baseline severity of airflow limitation, and white blood cell count that were also associated with an increased risk of moderate to severe exacerbations (all P <.001).Conclusion: Presence of high depressive symptoms at baseline were associated with subsequent moderate-severe exacerbations and hospital admissions in patients with COPD over 3 years, independent of a history of exacerbations and other demographic and clinical factors. Targeted personalized medicinethat focuses both on AECOPD risk and depression may be a step forward to improving prognosis of patients with COPD. (C) 2017 AMDA - The Society for Post-Acute and Long-Term Care Medicine.

KW - COPD

KW - depression

KW - longitudinal study

KW - acute exacerbations

KW - AECOPD

KW - hospitalization

KW - previous history of exacerbation

KW - OBSTRUCTIVE PULMONARY-DISEASE

KW - SYSTEMIC INFLAMMATION

KW - ANXIETY

KW - IMPACT

KW - RISK

KW - QUESTIONNAIRE

KW - READMISSION

KW - MORTALITY

U2 - 10.1016/j.jamda.2017.05.024

DO - 10.1016/j.jamda.2017.05.024

M3 - Article

C2 - 28733182

SN - 1525-8610

VL - 18

SP - 955

EP - 959

JO - Journal of the American Medical Directors Association

JF - Journal of the American Medical Directors Association

IS - 11

ER -

The Association of Depressive Symptoms With Rates of Acute Exacerbations in Patients With COPD: Results From a 3-year Longitudinal Follow-up of the ECLIPSE Cohort

Abstract

Keywords

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