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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/18853

Title: One-year change in health status and subsequent outcomes in COPD
Authors: Wilke, Sarah
Jones, Paul W.
Muellerova, H.
Vestbo, Jorgen
Tal-Singer, Ruth
Franssen, Frits M. E.
Agusti, Alvar
Bakke, Per S.
Calverley, Peter M.
Coxson, Harvey O.
Crim, Courtney
Edwards, Lisa D.
Lomas, David A.
MacNee, William
Rennard, Stephen I.
Yates, Julie C.
Wouters, Emiel F. M.
SPRUIT, Martijn A.
Issue Date: 2015
Publisher: BMJ PUBLISHING GROUP
Citation: THORAX, 70 (5), p. 420-425
Abstract: Background Poor health status has been associated with morbidity and mortality in patients with COPD. To date, the impact of changes in health status on these outcomes remains unknown. Aims To explore the relationship of clinically relevant changes in health status with exacerbation, hospitalisation or death in patients with COPD. Methods Characteristics and health status (St George's Respiratory Questionnaire, SGRQ) were assessed over a period of 3 years in 2138 patients with COPD enrolled in the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study: a longitudinal, prospective, observational study. Associations between change in health status (=4 units in SGRQ score) during year 1 and time to first exacerbation, hospitalisation and death during 2-year follow-up were assessed using Kaplan-Meier plots and log-rank test. Results 1832 (85.7%) patients (age 63.4 +/- 7.0 years, 65.4% male, FEV1 48.7 +/- 15.6% predicted) underwent assessment at baseline and 1 year. Compared with those who deteriorated, patients with improved or stable health status in year 1 have a lower likelihood of exacerbation (HR 0.78 (95% CI 0.67 to 0.89), p<0.001 and 0.84 (0.73 to 0.97), p=0.016, respectively), hospitalisation (0.72 (0.58 to 0.90), p=0.004 and 0.77 (0.62 to 0.96), p=0.023, respectively) or dying (0.61 (0.39 to 0.95), p=0.027 and 0.58 (0.37 to 0.92), p=0.019, respectively) during 2-year follow-up. This effect persisted after stratification for age and the number of exacerbations and hospitalisations during the first year of the study. Conclusions Patients with stable or improved health status during year 1 of ECLIPSE had a lower likelihood of exacerbation, hospitalisation or dying during 2-year follow-up. Interventions that stabilise and improve health status may also improve outcomes in patients with COPD.
Notes: [Wilke, Sarah; Franssen, Frits M. E.; Wouters, Emiel F. M.; Spruit, Martijn A.] Ctr Expertise Chron Organ Failure, CIRO, Dept Res & Educ, NL-6085 NM Horn, Netherlands. [Jones, Paul W.] St Georges Univ London, Div Clin Sci, London, England. [Muellerova, H.] GlaxoSmithKline, Resp Epidemiol, Uxbridge, Middx, England. [Vestbo, Jorgen] Gentofte Hosp Hellerup, Dept Resp Med, Gentofte, Denmark. [Vestbo, Jorgen] Univ Hosp South Manchester NHS Fdn, Manchester Acad Hlth Sci Ctr, Res Grp, Manchester, Lancs, England. [Tal-Singer, Ruth] GlaxoSmithKline, Res & Dev, King Of Prussia, PA USA. [Agusti, Alvar] Univ Barcelona, IDIBAPS, Hosp Clin, Thorax Inst, Barcelona, Spain. [Agusti, Alvar] CIBER Enfermedades Resp CIBERES, Barcelona, Spain. [Bakke, Per] Univ Bergen, Inst Clin Sci, Dept Thorac Med, Haukeland Univ Hosp, Bergen, Norway. [Calverley, Peter M.] Aintree Univ Hosp NHS Fdn Trust, Div Infect, Liverpool L9 7AL, Merseyside, England. [Calverley, Peter M.] Aintree Univ Hosp NHS Fdn Trust, Immun Clin Sci Ctr, Liverpool L9 7AL, Merseyside, England. [Coxson, Harvey O.] Univ British Columbia, Vancouver Gen Hosp, Dept Radiol, Vancouver, BC V5Z 1M9, Canada. [Crim, Courtney; Edwards, Lisa D.; Yates, Julie C.] GlaxoSmithKline, Res Triangle Pk, NC USA. [Lomas, David A.] UCL, Wolfson Inst Biomed Res, London, England. [MacNee, William] Univ Edinburgh, Queens Med Res Inst, MRC Ctr Inflammat Res, Edingburgh, Scotland. [Rennard, Stephen I.] Univ Nebraska Med Ctr, Div Pulm Crit Care Sleep & Allergy, Omaha, NE USA. [Wouters, Emiel F. M.] Maastricht Univ, Med Ctr, Dept Resp Med, NL-6200 MD Maastricht, Netherlands. [Spruit, Martijn A.] Hasselt Univ, BIOMED Biomed Res Inst, REVAL Rehabil Res Ctr, Fac Med & Life Sci, Diepenbeek, Belgium. Correspondence to Sarah Wilke, Department of Research & Education, CIRO+, Centre of Expertise for Chronic Organ Failure, Hornerheide 1, NM Horn 6085, The Netherlands; sarahwilke@ciro-horn.nl
URI: http://hdl.handle.net/1942/18853
DOI: 10.1136/thoraxjnl-2014-205697
ISI #: 000352846600006
ISSN: 0040-6376
Category: A1
Type: Journal Contribution
Validation: ecoom, 2016
Appears in Collections: Research publications

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