Risk factors for rehospitalisation in COPID: role of health status, anxiety and depression
Risk factors for rehospitalisation in COPID: role of health status, anxiety and depression
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DOI：
10.1183/09031936.05.00078504
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发表时间：
2005-09-01
影响因子：
24.3
通讯作者：
Bakke, P
中科院分区：
文献类型：
--
作者：
Gudmundsson, G;Gislason, T;Bakke, P
本研究的目的是分析慢性阻塞性肺疾病患者再住院的风险和相关的危险因素，这项前瞻性研究包括416例患者从大学医院在每个北欧国家。数据包括406例患者的人口统计学信息、肺功能测定、合并症和12个月随访。采用医院焦虑抑郁量表和圣乔治呼吸问卷（SGRQ）对所有患者进行评定，其中246例（60.6%）在12个月内再次入院。再次入院的患者肺功能和健康状况较低。第一秒用力呼气量（FEV 1）和健康状况低是再次入院的独立预测因素。预测FEV 1每增加10%，风险比（HR; 95% CI）为0.82（0.74-0.90），SGRO总分每增加4个单位，风险比（HR; 95% CI）为1.06（1.02-1.10）。焦虑受试者（HR 1.76（1.16-2.68））和健康状况较低（SGRO总分>60个单位）的受试者再次住院的风险也增加。当比较SGRQ中的不同子量表时，发现再住院风险与活动量表之间的关系最密切（HR 1.07（1.03-1.11）每增加4个单位）。在低健康状况患者中，焦虑是再住院的重要风险因素。这可能对患者治疗很重要，需要进一步研究。
The aim of the present study was to analyse the risk of rehospitalisation in patients with chronic obstructive pulmonary disease and associated risk factors.This prospective study included 416 patients from a university hospital in each of the five Nordic countries. Data included demographic information, spirometry, comorbidity and 12 month follow-up for 406 patients. The hospital anxiety and depression scale and St. George's Respiratory Questionnaire (SGRQ) were applied to all patients.The number of patients that had a re-admission within 12 months was 246 (60.6%). Patients that had a re-admission had lower lung function and health status. A low forced expiratory volume in one second (FEV1) and health status were independent predictors for re-admission. Hazard ratio (HR; 95% CI) was 0.82 (0.74-0.90) per 10% increase of the predicted FEV1 and 1.06 (1.02-1.10) per 4 units increase in total SGRO score. The risk of rehospitalisation was also increased in subjects with anxiety (HR 1.76 (1.16-2.68)) and in subjects with low health status (total SGRO score >60 units). When comparing the different subscales in the SGRQ, the closest relation between the risk of rehospitalisation was seen with the activity scale (HR 1.07 (1.03-1.11) per 4 unit increase).In patients with low health status, anxiety is an important risk factor for rehospitalisation. This may be important for patient treatment and warrants further studies.