Lewis Katz School of Medicine at Temple University, Department of Thoracic Medicine and Surgery, Division of Pulmonary and Critical Care Medicine, 3401 North Broad Street Philadelphia, PA, 19140, USA.
University of Minnesota, Minneapolis, MN, USA.
Respir Med. 2021 Sep;186:106526. doi: 10.1016/j.rmed.2021.106526. Epub 2021 Jun 29.
Acute exacerbations negatively impact quality of life in patients with chronic obstructive pulmonary disease (COPD), but the impact of hospitalized exacerbations on quality of life is not clear. We hypothesized that patients with hospitalized exacerbations would benefit from hospitalization and experience improvement in general and disease-specific quality of life (as measured by the St. George's respiratory questionnaire (SGRQ) and the medical outcomes study 36-item short form health survey (SF-36)) compared to those without exacerbations, or with non-hospitalized acute exacerbations.
1219 COPD patients enrolled in either the simvastatin for the prevention of exacerbations in moderate-to severe COPD Trial (STATCOPE) or azithromycin for prevention of exacerbations of COPD trial (MACRO) were analyzed. Demographic information, spirometry, and symptom scores were noted at baseline. Exacerbation events and changes in quality of life scores were assessed over a mean of 538 days of follow-up.
Of patients studied, 25.6% were hospitalized, 44.0% had at least one outpatient exacerbation, and 30.4% had no exacerbation. Baseline SGRQ and SF-36 scores were severely impaired in all groups studied. Over time, SF-36 scores did not change significantly between groups. SGRQ symptom domain scores improved in other groups but did not improve in those hospitalized for a COPD exacerbation.
At baseline, patients hospitalized for acute exacerbations of COPD had more impaired quality of life scores. Over time, SGRQ symptom domain scores improved in other groups but did not in those who were hospitalized. Other measurements of quality of life were not improved by hospitalization for COPD.
慢性阻塞性肺疾病（COPD）患者的急性加重会对其生活质量产生负面影响，但住院加重对生活质量的影响尚不清楚。我们假设，与无加重或非住院急性加重的患者相比，住院急性加重的患者将从住院中受益，并改善一般和特定于疾病的生活质量（通过圣乔治呼吸问卷（SGRQ）和医疗结果研究 36 项短表单健康调查（SF-36）进行衡量）。
对参与辛伐他汀预防中重度 COPD 加重试验（STATCOPE）或阿奇霉素预防 COPD 加重试验（MACRO）的 1219 例 COPD 患者进行了分析。在基线时记录了人口统计学信息、肺功能和症状评分。在平均 538 天的随访期间评估了加重事件和生活质量评分的变化。
在所研究的患者中，25.6%住院，44.0%至少有一次门诊加重，30.4%无加重。所有研究组的 SGRQ 和 SF-36 评分基线均严重受损。随着时间的推移，SF-36 评分在各组之间没有明显变化。其他组的 SGRQ 症状域评分有所改善，但住院治疗 COPD 加重的组没有改善。
在基线时，因 COPD 急性加重而住院的患者生活质量评分受损更严重。随着时间的推移，其他组的 SGRQ 症状域评分有所改善，但住院治疗 COPD 的组没有改善。其他生活质量测量指标未因 COPD 住院而改善。
