To measure the quality of life (QOL) in patients with acute exacerbation of COPD (AECOPD) and the frequency of potential risk factors, and to evaluate the association of risk factors with poor QOL in patients with AECOPD.
A prospective cohort study of 132 patients with moderate to severe COPD admitted for acute exacerbations to two large general hospitals were studied. The St George QOL (SGQOL) scale at 6-month post discharge and hospital readmissions during the 6-month follow up period were determined. Socio-demographic, clinical and patient care characteristics, including depression and spirometry were ascertained in the stable state before discharge and at one-month post discharge.
There was a high prevalence of current or ex-heavy smokers, depression and consumption of psychotropic drugs, and low prevalence of care giver support, pulmonary rehabilitation and vaccination. At 6-month post-discharge, the mean scores for the different domains were 53.7 for Symptoms; 63.7 for Activity; 31.4 for Impact; and the mean of overall Total scores was 44.8. Multiple regression analysis showed that worse Symptoms Score of SGQOL was predicted by readmissions (≥1) during the 6-month follow up period (p<0.001), use of psychotropic drugs (p<0.01), severe dyspnea (degree of dyspnea ≥3) (p<0.01) and previous frequent hospital readmissions (≥2) (p<0.01). Worse Activity Score was significantly predicted by previous frequent readmissions (p<0.001), older age (>70 yrs) (p<0.01) and lower FEV1% (<45%) (p<0.01). Worse Impact Score was significantly predicted by psychiatric disorder (HAD≥8) (p<0.001) and previous frequent readmissions (p<0.01). Worse Total Score of SGQOL was predicted by psychiatric disorder (HAD≥8) (p<0.001), previous frequent readmissions (p<0.01), and readmissions during the 6-month follow up period (p<0.05).
Poor QOL in patients with COPD exacerbation was predicted by disease severity, psychosocial and health care factors.
Modifications of these factors are potential methods for the improvement of QOL in patients with acute exacerbations of COPD.
C. Zhenying, National University of Singapore