Pneumon (Jan 2011)
Correlation between frequency of hospitalization of patients with severe copd and severity indices
Abstract
SUMMARY.Backgrou nd: Several parameters have been proposed as riskfactors for hospitalization of patients with chronic obstructivepulmonary disease (COPD). Objectives: The aim of this studywas to investigate the association between changes in parametersexpressing various different aspects of disease severity and thefrequency of hospitalization of patients with severe COPD withoutco-morbidities. Population and methods: Of 117 patients withsevere COPD recruited for prospective study, 74 completed 2-yearmonitoring and were classified into 2 groups according to their frequencyof hospitalization: Group A (n=39) ≤2 hospitalizations/year,Group B >2 hospitalizations/year (n=35). Parameters measured atbaseline and 2 years included: FEV1 % pred, FEV1/FVC ratio, ratio ofinspiratory capacity (IC) to total lung capacity (TLC)(IC/TLC), bodymass index (BMI), fat free mass index (FFMI), 6 minute walk distance(6MWD), the Borg dyspnoea scale before and after 6MWD, dyspnoeaaccording to the Medical Research Council (MRC) scale, pH and8-isoprostane in exhaled breath condensate (EBC), serum levels ofC-reactive protein (CRP) and fibrinogen, arterial blood gases, theBMI, airflow obstruction, dyspnoea, and exercise capacity (BODE)index and quality of life. Results: The patients with more frequenthospitalizations showed greater change in the baseline study variablesafter 2 years. The specific differences were loss of muscle mass,deterioration of airway obstruction, decrease in exercise capacity,increase in airways and systemic inflammation and impairment inquality of life. The most significant changes found to be associatedwith hospitalization frequency using a regression model were inCRP, 6MWD, fibrinogen, 8-isoprostane and BODE. Co nclusions:In this selected cohort of patients with severe COPD, increased hospitalizationfrequency was associated with changes in parametersexpressing deterioration in exercise capacity and in systemic andairways inflammation. Pneumon 2011, 24(2):164-170.
