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Original Research: COPD |

Self-Rated Health Predicts Acute Exacerbations and Hospitalizations in Patients With COPD

Jerneja Farkas, PhD; Mitja Kosnik, PhD; Matjaz Flezar, PhD; Stanislav Suskovic, PhD, FCCP; Mitja Lainscak, PhD
Author and Funding Information

From the Faculty of Medicine (Dr Farkas), University of Ljubljana, Ljubljana, Slovenia; the Division of Cardiology (Dr Lainscak), University Clinic of Respiratory and Allergic Diseases Golnik (Drs Kosnik, Flezar, and Suskovic), Golnik, Slovenia; and the Division of Applied Cachexia Research (Dr Lainscak), Charite Universitaetsmedizin Berlin, Berlin, Germany.

Correspondence to: Jerneja Farkas, PhD, Faculty of Medicine University of Ljubljana, Zaloska cesta 4, SI-1000 Ljubljana, Slovenia; e-mail: jerneja.farkas@mf.uni-lj.si


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;138(2):323-330. doi:10.1378/chest.09-2459
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Background:  Self-rated health predicts outcome in chronic disease, but such information is scarce in COPD. We aimed to assess self-rated health as an outcome predictor in carefully characterized patients with this condition.

Methods:  This was a prospective study in 127 clinically stable patients with COPD (64 ± 8 years, 79% men, 82% Global Initiative for Chronic Obstructive Lung Disease stage II or III). Self-rated health was assessed using a 5-grade Likert scale ranging from very poor to very good.

Results:  During 26.0 ± 4.9 months of follow-up, 78 patients experienced acute exacerbation, 39 were hospitalized, and 10 died. Poor or very poor self-rated health was reported by 19 patients (15%) and was more common in patients experiencing acute exacerbations (20% vs 6%, P = .027) and hospitalizations (19% vs 5%, P = .039). Kaplan-Meier curves demonstrated more acute exacerbations (P = .003) and hospitalizations (P = .008) in patients with poor or very poor self-rated health. In a fully adjusted Cox model of proportional hazard, poor or very poor self-rated health remained predictive of acute exacerbations (hazard ratio [HR], 1.80; 95% CI, 1.03-3.11) and hospitalizations (HR, 1.93; 95% CI, 1.12-3.68) but not of death.

Conclusions:  This study suggests that self-rated health is predictive of acute exacerbations and hospitalizations. Although prediction of mortality was limited, the study is supportive of self-rated health testing in COPD.

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