A simple score for assessing stable chronic obstructive pulmonary disease
A simple score for assessing stable chronic obstructive pulmonary disease
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DOI：
10.1093/qjmed/hcl110
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发表时间：
2006-11-01
影响因子：
13.3
通讯作者：
Capelastegui, A.
中科院分区：
文献类型：
--
作者：
Esteban, C.;Quintana, J. M.;Capelastegui, A.
背景：慢性阻塞性肺疾病(COPD)通常使用FEV1来评估，以确定疾病的诊断和严重程度。目的：评价健康-活动-呼吸困难-梗阻(HADO)评分在COPD严重程度分级和预后预测中的作用。设计：前瞻性纵向临床研究。方法：对某教学医院5个门诊的611例COPD稳定期患者进行研究。我们测量了呼吸困难程度、肺功能(通过肺活量测定)、自我报告的日常体力活动水平和总体健康状况。结果：根据Hado评分，COPD轻度患者占26.7%，中度患者占53.3%，重度患者占20%。在这三个严重程度与HRQL参数和生命状态之间有统计学意义的相关性。在调整相关协变量后，HADO评分可以可靠地预测生存和生命状态。讨论：HADO评分在门诊很容易获得，并根据疾病严重程度区分COPD患者组。HADO评分预测3年后死亡率优于FEV1%。
Background: Chronic obstructive pulmonary disease (COPD) is usually assessed using FEV1 to establish the diagnosis and the severity of the disease. However, COPD is now considered a systemic disease.To evaluate the utility of the Health-Activity-Dyspnoea-Obstruction (HADO) score for classifying the severity of COPD and predicting outcomes.Design: Prospective longitudinal clinical study.Methods: We studied 611 consecutive patients with stable COPD in five out-patient clinics of a teaching hospital. We measured dyspnoea degree, pulmonary function (by spirometry), self-reported level of daily physical activity and overall health condition. Outcome measures included health-related quality of life (HRQoL) parameters (as measured by the generic SF-36 Health Survey and by two specific questionnaires, the St George Respiratory Questionnaire and the Chronic Respiratory Questionnaire) and mortality at 3 years follow-up.Results: Based on the HADO score, COPD was classified as mild in 26.7% of patients, moderate in 53.3%, and severe in 20%. There were statistically significant correlations between these three levels of severity and HRQoL parameters and vital status. After adjustment for relevant covariates, the HADO score reliably predicted survival and vital status.Discussion: The HADO score can be easily obtained in an out-patient clinic, and distinguishes groups of COPD patients by their disease severity. The HADO score is better than FEV1% alone for predicting mortality at 3 years.