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Persistent disabling breathlessness in chronic obstructive pulmonary disease

Sundh, Josefin and Ekström, Magnus LU (2016) In International Journal of COPD 11(1). p.2805-2812
Abstract

Objective: To determine the prevalence, change in breathlessness status over time, and risk factors for disabling and persistent disabling breathlessness in relation to treatments in chronic obstructive pulmonary disease (COPD). Materials and methods: Longitudinal analysis of data from the Swedish National Register of COPD with breathlessness measured using modified Medical Research Council (mMRC) scores at two subsequent visits. Prevalence of disabling breathlessness (mMRC ≥2 at baseline) and persistent disabling breathlessness (disabling breathlessness at baseline and follow-up) was investigated in relation to COPD treatment. Risk factors for disabling breathlessness, change from non-disabling to disabling breathlessness, and... (More)

Objective: To determine the prevalence, change in breathlessness status over time, and risk factors for disabling and persistent disabling breathlessness in relation to treatments in chronic obstructive pulmonary disease (COPD). Materials and methods: Longitudinal analysis of data from the Swedish National Register of COPD with breathlessness measured using modified Medical Research Council (mMRC) scores at two subsequent visits. Prevalence of disabling breathlessness (mMRC ≥2 at baseline) and persistent disabling breathlessness (disabling breathlessness at baseline and follow-up) was investigated in relation to COPD treatment. Risk factors for disabling breathlessness, change from non-disabling to disabling breathlessness, and persistent disabling breathlessness were analyzed using multiple logistic regression. Results: A total of 1,689 patients were included in the study with a median follow-up of 12 months (interquartile range: 4 months). Prevalence of disabling breathlessness was 54% at baseline. Persistent disabling breathlessness was present in 43% of patients despite treatment and in 74% of patients despite combined inhaled triple therapy and physiotherapy. Risk factors for disabling breathlessness or change to disabling breathlessness were higher age, lower lung function, frequent exacerbations, obesity, heart failure, depression, and hypoxic respiratory failure (all P<0.05). Persistent disabling breathlessness was associated with lower lung function and ischemic heart disease (all P<0.05). Conclusion: Disabling breathlessness is common in COPD despite treatment, which calls for improved symptomatic treatments and consideration of factors influencing disabling breathlessness. Factors influencing disabling breathlessness should be considered for COPD management.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Breathlessness, COPD, Dyspnea, Longitudinal analysis, Risk factors, Treatment
in
International Journal of COPD
volume
11
issue
1
pages
8 pages
publisher
Dove Press
external identifiers
  • scopus:84995662757
  • wos:000387436400001
ISSN
1176-9106
DOI
10.2147/COPD.S119992
language
English
LU publication?
yes
id
ff973af2-3b22-42e5-980e-d6ca1cc147f5
date added to LUP
2016-12-05 08:50:39
date last changed
2017-03-07 03:00:06
@article{ff973af2-3b22-42e5-980e-d6ca1cc147f5,
  abstract     = {<p>Objective: To determine the prevalence, change in breathlessness status over time, and risk factors for disabling and persistent disabling breathlessness in relation to treatments in chronic obstructive pulmonary disease (COPD). Materials and methods: Longitudinal analysis of data from the Swedish National Register of COPD with breathlessness measured using modified Medical Research Council (mMRC) scores at two subsequent visits. Prevalence of disabling breathlessness (mMRC ≥2 at baseline) and persistent disabling breathlessness (disabling breathlessness at baseline and follow-up) was investigated in relation to COPD treatment. Risk factors for disabling breathlessness, change from non-disabling to disabling breathlessness, and persistent disabling breathlessness were analyzed using multiple logistic regression. Results: A total of 1,689 patients were included in the study with a median follow-up of 12 months (interquartile range: 4 months). Prevalence of disabling breathlessness was 54% at baseline. Persistent disabling breathlessness was present in 43% of patients despite treatment and in 74% of patients despite combined inhaled triple therapy and physiotherapy. Risk factors for disabling breathlessness or change to disabling breathlessness were higher age, lower lung function, frequent exacerbations, obesity, heart failure, depression, and hypoxic respiratory failure (all P&lt;0.05). Persistent disabling breathlessness was associated with lower lung function and ischemic heart disease (all P&lt;0.05). Conclusion: Disabling breathlessness is common in COPD despite treatment, which calls for improved symptomatic treatments and consideration of factors influencing disabling breathlessness. Factors influencing disabling breathlessness should be considered for COPD management.</p>},
  author       = {Sundh, Josefin and Ekström, Magnus},
  issn         = {1176-9106},
  keyword      = {Breathlessness,COPD,Dyspnea,Longitudinal analysis,Risk factors,Treatment},
  language     = {eng},
  month        = {11},
  number       = {1},
  pages        = {2805--2812},
  publisher    = {Dove Press},
  series       = {International Journal of COPD},
  title        = {Persistent disabling breathlessness in chronic obstructive pulmonary disease},
  url          = {http://dx.doi.org/10.2147/COPD.S119992},
  volume       = {11},
  year         = {2016},
}