Physical Activity, Health Status and Risk of Hospitalization in Patients with Severe Chronic Obstructive Pulmonary Disease
Physical Activity, Health Status and Risk of Hospitalization in Patients with Severe Chronic Obstructive Pulmonary Disease
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DOI：
10.1159/000296504
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发表时间：
2010-01-01
期刊：
影响因子：
3.7
通讯作者：
Sciurba, Frank
中科院分区：
文献类型：
--
作者：
Benzo, Roberto P.;Chang, Chung-Chou H.;Sciurba, Frank
背景：慢性阻塞性肺疾病 (COPD) 是导致死亡的主要原因，70% 的 COPD 费用来自住院治疗。自我报告的日常身体活动和健康状况已被报告为慢性阻塞性肺病住院的预测因素，但并未进行常规评估。目的：我们测试了这样一个假设：在一组特征明确的严重肺气肿患者中，自我报告的日常体力活动和通过一个简单问题评估的健康状况是住院的预测因素。方法：研究人员收集了 597 名严重肺气肿患者的日常体力活动和健康状况数据，通过一个简单的问题进行评估，并测试了这些患者报告的结果与下一年住院发生的关联。使用多重逻辑回归分析来确定随机分组后前 12 个月内住院的预测因素。结果：在调整所有单变量显着预测因素后，假设中测试的两个变量是住院的显着预测因素：每周 1-2 小时的体力活动具有保护作用 [比值比 (OR) 0.60；比值比 (OR) 0.60； 95% 置信区间 (95% CI) 0.41-0.88] 和自我报告的健康状况为一般或较差具有有害影响（OR 1.57；95% CI 1.10-2.23）。此外，另外两个变量在多变量模型中变得显着：总肺活量（每增加 10%）具有保护作用（OR 0.88；95% CI 0.78-0.99），自我报告的焦虑具有有害作用（OR 1.75；95% CI 1.13-2.70）。结论：自我报告的日常体力活动和健康状况与 COPD 住院独立相关。我们的研究结果通过简单的问题进行评估，表明患者报告的结果在开发易于使用的风险评估工具方面的价值。版权所有 (C) 2010 S. Karger AG，巴塞尔
Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of death and 70% of the cost of COPD is due to hospitalizations. Self-reported daily physical activity and health status have been reported as predictors of a hospitalization in COPD but are not routinely assessed. Objectives: We tested the hypothesis that self-reported daily physical activity and health status assessed by a simple question were predictors of a hospitalization in a well-characterized cohort of patients with severe emphysema. Methods: Investigators gathered daily physical activity and health status data assessed by a simple question in 597 patients with severe emphysema and tested the association of those patient-reported outcomes to the occurrence of a hospitalization in the following year. Multiple logistic regression analyses were used to determine predictors of hospitalization during the first 12 months after randomization. Results: The two variables tested in the hypothesis were significant predictors of a hospitalization after adjusting for all univariable significant predictors: 1 2 h of physical activity per week had a protective effect [odds ratio (OR) 0.60; 95% confidence interval (95% CI) 0.41-0.88] and self-reported health status as fair or poor had a deleterious effect (OR 1.57; 95% CI 1.10-2.23). In addition, two other variables became significant in the multivariate model: total lung capacity (every 10% increase) had a protective effect (OR 0.88; 95% CI 0.78-0.99) and self-reported anxiety had a deleterious effect (OR 1.75; 95% CI 1.13-2.70). Conclusion: Self-reported daily physical activity and health status are independently associated with COPD hospitalizations. Our findings, assessed by simple questions, suggest the value of patient-reported outcomes in developing risk assessment tools that are easy to use. Copyright (C) 2010 S. Karger AG, Basel