Self-rated health (SRH) predicts morbidity and mortality in patients with chronic disease. In chronic obstructive pulmonary disease (COPD), limited data on SRH exists. We aimed to test the hypothesis whether SRH predicts outcome in patients with COPD.
This prospective study enrolled 127 stable ambulatory patients with COPD (age 65 ± 8 years, 79% men, GOLD II –51, GOLD III –53, GOLD IV –23). SRH was assessed with 5-item likert scale (very poor, poor, fair, good, very good). Primary end-point was combination of mortality and hospitalization.
Most patients rated their health as fair (60%) and SRH was poor or very poor in 19 (15%) patients. During follow-up of 790 ± 149 days, 10 (8%) patients died, 39 (31%) were hospitalized and 78 (61%) had acute exacerbation (AE) of COPD. More patients with poor or very poor SRH met primary end point (63% vs 31%, p = 0.006) or have experienced AE COPD (84% vs 57%, p = 0.027) whilst mortality did not differ (11% vs 7%, p = 0.642). In univariate models, poor or very poor SRH increased risk for primary end-point (hazard ratio [HR] 2.46, 95% confidence interval [CI] 1.27–4.78) and AE COPD (HR 2.26, 95% CI 1.30–3.94). After adjustment for age, gender, previous hospitalization, GOLD, and BODE index, poor or very poor SRH independently predicted AE COPD (HR 1.89, 95% CI 1.03–3.48) but not primary end point (HR 1.16, 95% CI 0.55–2.48).
Poor or very poor SRH was present in 15% of patients with COPD and independently predicted AE COPD. Our findings have to be validated in a larger sample with higher mortality rate.
SRH could be used as an additional tool to risk-stratify patients with COPD.
Jerneja Farkas, No Financial Disclosure Information; No Product/Research Disclosure Information