Antoniu Sabina Antonela, Apostol Anca, Boiculese Lucian Vasile
Department of Medicine II-Nursing/Palliative Care, University of Medicine and Pharmacy Grigore T Popa, Iasi, Romania.
Faculty of Medicine, University of Medicine and Pharmacy Grigore T Popa, Iasi, Romania.
Clin Respir J. 2019 Dec;13(12):735-740. doi: 10.1111/crj.13083. Epub 2019 Aug 30.
In COPD management, the improvement of the health status by alleviating respiratory symptoms is among the main aims. However, little is known on the prevalence and burden of extra-respiratory symptoms which can also be distressing especially during a COPD exacerbation.
To evaluate the prevalence of extra-respiratory symptoms and their impact on health and functional statuses in patients hospitalized for a COPD exacerbation.
Health status was evaluated with the COPD Assessment Test (CAT), functional status with Karnofsky index, and presence and severity of respiratory symptoms were evaluated with Edmonton Symptom Assessment Scale (ESAS).
In a sample of 47 patients, fatigue was found to be the most prevalent 95.7% followed by pain 74.5%, lack of appetite 72.3%, depression and anxiety (each in 63.8%), drowsiness 59.6% and nausea 31.9%. The concomitant presence of an increasing number of symptoms (three, four, five, six or seven) was individually associated with worse health status or of functional status (eg, CAT score in patients with three most prevalent symptoms, fatigue, pain and lack of appetite 29.6 vs 25.1, P = .006 in patients without them; Karnofsky index scores in patients with the four most prevalent symptoms 52 vs 65.6, P = .001). Linear regressions confirmed that the increase in the number of concomitant extra-respiratory symptoms significantly correlated with the worsening of health/functional status. In conclusion, the burden of extra-respiratory symptoms in patients with hospitalized for a COPD exacerbation is significant and impact significantly on health/functional status.
在慢性阻塞性肺疾病（COPD）的管理中，通过缓解呼吸道症状来改善健康状况是主要目标之一。然而，对于呼吸道外症状的患病率和负担知之甚少，这些症状在COPD急性加重期也可能令人痛苦。
评估因COPD急性加重住院患者呼吸道外症状的患病率及其对健康和功能状态的影响。
采用慢性阻塞性肺疾病评估测试（CAT）评估健康状况，采用卡诺夫斯基指数评估功能状态，采用埃德蒙顿症状评估量表（ESAS）评估呼吸道症状的存在情况和严重程度。
在47例患者的样本中，发现疲劳最为普遍（95.7%），其次是疼痛（74.5%）、食欲不振（72.3%）、抑郁和焦虑（各占63.8%）、嗜睡（59.6%）和恶心（31.9%）。越来越多症状（三种、四种、五种、六种或七种）的同时出现分别与较差的健康状况或功能状态相关（例如，三种最常见症状，即疲劳、疼痛和食欲不振的患者的CAT评分，有这些症状的患者为29.6，无这些症状的患者为25.1，P = 0.006；四种最常见症状的患者的卡诺夫斯基指数评分，有这些症状的患者为52，无这些症状的患者为65.6，P = 0.001）。线性回归证实，呼吸道外伴随症状数量的增加与健康/功能状态的恶化显著相关。总之，因COPD急性加重住院患者的呼吸道外症状负担较重，对健康/功能状态有显著影响。
