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在慢性阻塞性肺疾病严重急性加重期,体格检查结果与患者报告的结局指标相关性较差。

Physical Tests Are Poorly Related to Patient-Reported Outcome Measures during Severe Acute Exacerbations of COPD.

作者信息

Quadflieg Kirsten, Machado Ana, Haesevoets Sarah, Daenen Marc, Thomeer Michiel, Ruttens David, Spruit Martijn A, Burtin Chris

机构信息

REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium.

BIOMED-Biomedical Research Institute, Hasselt University, 3590 Diepenbeek, Belgium.

出版信息

J Clin Med. 2021 Dec 28;11(1):150. doi: 10.3390/jcm11010150.

Abstract

Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) have a negative impact on patients' health status, including physical function and patient-reported outcomes. We aimed to explore the associations between physical tests and patient-reported outcome measures (PROMs) in hospitalised patients for an AECOPD. Patients were assessed on the day of discharge. Quadriceps force, handgrip strength, short physical performance battery (SPPB), five-repetition sit-to-stand test (5STS), four-meter gait speed test (4MGS), balance test, six-minute walk test (6MWT), COPD Assessment Test (CAT), London Chest Activity of Daily Living scale (LCADL), modified Medical Research Council (mMRC) dyspnea scale, Checklist of Individual Strength (CIS)-fatigue subscale, and Patient Health Questionnaire (PHQ-9) were collected. Sixty-nine patients with an AECOPD were included (54% female; age 69 ± 9 years; FEV 39.2 (28.6-49.1%) predicted). Six-minute walk distance was strongly correlated with mMRC (: -0.64, < 0.0001) and moderately correlated with LCADL total score, subscales self-care and household activities ( ranging from -0.40 to -0.58, < 0.01). Moreover, 4MGS was moderately correlated with mMRC (: -0.49, < 0.0001). Other correlations were weak or non-significant. During a severe AECOPD, physical tests are generally poorly related to PROMs. Therefore, a comprehensive assessment combining both physical tests and PROMs needs to be conducted in these patients to understand their health status.

摘要

慢性阻塞性肺疾病急性加重(AECOPD)会对患者的健康状况产生负面影响,包括身体功能和患者报告的结局。我们旨在探讨因AECOPD住院患者的体能测试与患者报告结局指标(PROMs)之间的关联。在出院当天对患者进行评估。收集了股四头肌力量、握力、简短体能表现电池测试(SPPB)、五次坐立试验(5STS)、四米步态速度测试(4MGS)、平衡测试、六分钟步行试验(6MWT)、慢性阻塞性肺疾病评估测试(CAT)、伦敦胸部日常生活活动量表(LCADL)、改良医学研究委员会(mMRC)呼吸困难量表、个人力量清单(CIS)-疲劳子量表和患者健康问卷(PHQ-9)。纳入了69例AECOPD患者(54%为女性;年龄69±9岁;FEV为预测值的39.2(28.6-49.1%))。六分钟步行距离与mMRC呈强相关(r:-0.64,P<0.0001),与LCADL总分、自我护理和家务活动子量表呈中度相关(r范围为-0.40至-0.58,P<0.01)。此外,4MGS与mMRC呈中度相关(r:-0.49,P<0.0001)。其他相关性较弱或无统计学意义。在严重AECOPD期间,体能测试与PROMs通常相关性较差。因此,需要对这些患者进行体能测试和PROMs相结合的综合评估,以了解他们的健康状况。

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本文引用的文献

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Exacerbations of COPD.COPD 恶化。
Eur Respir Rev. 2018 Mar 14;27(147). doi: 10.1183/16000617.0103-2017. Print 2018 Mar 31.

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