scholarly journals Fatigue and multidimensional disease severity in chronic obstructive pulmonary disease

2010 ◽  
Vol 5 ◽  
Author(s):  
Deniz Inal-Ince ◽  
Sema Savci ◽  
Melda Saglam ◽  
Ebru Calik ◽  
Hulya Arikan ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Disease Severity ◽  
Airflow Obstruction ◽  
Muscle Endurance ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Bode Index ◽  
Peripheral Muscle ◽  
St George's Respiratory Questionnaire

Background and aims: Fatigue is associated with longitudinal ratings of health in patients with chronic obstructive pulmonary disease (COPD). Although the degree of airflow obstruction is often used to grade disease severity in patients with COPD, multidimensional grading systems have recently been developed. The aim of this study was to investigate the relationship between perceived and actual fatigue level and multidimensional disease severity in patients with COPD. Materials and methods: Twenty-two patients with COPD (aged 52-74 years) took part in the study. Multidimensional disease severity was measured using the SAFE and BODE indices. Perceived fatigue was assessed using the Fatigue Severity Scale (FSS) and the Fatigue Impact Scale (FIS). Peripheral muscle endurance was evaluated using the number of sit-ups, squats, and modified push-ups that each patient could do. Results: Thirteen patients (59%) had severe fatigue, and their St George’s Respiratory Questionnaire scores were significantly higher (p < 0.05). The SAFE index score was significantly correlated with the number of sit-ups, number of squats, FSS score and FIS score (p < 0.05). The BODE index was signif- icantly associated with the numbers of sit-ups, squats and modified push-ups, and with the FSS and FIS scores (p < 0.05). Conclusions: Peripheral muscle endurance and fatigue perception in patients with COPD was related to multidimensional disease severity measured with both the SAFE and BODE indices. Improvements in perceived and actual fatigue levels may positively affect multidimensional disease severity and health status in COPD patients. Further research is needed to investigate the effects of fatigue perception and exercise training on patients with different stages of multidimensional COPD severity.

scholarly journals Efficacy Of Unsupervised Home-Based Pulmonary Rehabilitation For Patients With Chronic Obstructive Pulmonary Disease

2020 ◽  
Author(s):  
Jang Ho Lee ◽  
Hyang Yi Lee ◽  
Youngwon Jang ◽  
Jae Seung Lee ◽  
Yeon-Mok Oh ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Pulmonary Rehabilitation ◽  
Airflow Obstruction ◽  
The Body ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Bode Index ◽  
Home Based ◽  
Hospital Visits

Abstract Background: Pulmonary rehabilitation (PR) is a well-established treatment for chronic obstructive pulmonary disease (COPD). The standard protocol for PR requires frequent hospital visits, which can be difficult for patients. We performed this study to assess whether unsupervised home-based PR (HBPR) is effective for patients with COPD.Methods: This investigation was a prospective cohort study. After assessing the outcome data, including the results of a COPD assessment test (CAT); the body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) index; a pulmonary function test; the modified Medical Research Council (mMRC) dyspnea scale; and the 6-min walking test (6MWT), specialists imparted education to patients about unsupervised HBPR. Patients who exercised more than three times per week were classified as the compliant group, and the others were categorized as the noncompliant group. Changes in the outcomes were compared between the compliant and noncompliant groups.Results: 41 patients were enrolled in this study. After 8 weeks of unsupervised HBPR, there were significant improvements in CAT scores, BODE index, and forced expiratory volume in 1 s among patients in the compliant group compared with those in the noncompliant group. Moreover, their CAT and mMRC scores improved significantly after 8 weeks compared with those at baseline. On the other hand, patients in the noncompliant group showed no significant improvement in any of the outcomes.Conclusions: Unsupervised HBPR can be effective for compliant patients with COPD. We recommend unsupervised HBPR for patients with COPD even when regular hospital visits for PR are not possible.Trial registration: NCT03754881

scholarly journals Success in Pulmonary Rehabilitation in Patients with Chronic Obstructive Pulmonary Disease

2010 ◽  
Vol 17 (5) ◽  
pp. 219-223 ◽  
Author(s):  
Adrienne S Scott ◽  
Marcel A Baltzan ◽  
Joel Fox ◽  
Norman Wolkove
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Pulmonary Rehabilitation ◽  
Airflow Obstruction ◽  
Successful Outcome ◽  
Chronic Obstructive ◽  
Walk Test ◽  
Hypoxemic Respiratory Failure ◽  
Obstructive Pulmonary Disease ◽  
St George's Respiratory Questionnaire

BACKGROUND: Pulmonary rehabilitation (PR) is beneficial for some, but not all, patients with chronic lung disease.OBJECTIVES: To determine the success rate of a comprehensive PR program for patients with chronic obstructive pulmonary disease (COPD) and to characterize the differences between responders and nonresponders.METHODS: A chart review was performed on patients with a clinical diagnosis of COPD who were referred for PR. Success was defined according to clinically important changes in St George’s Respiratory Questionnaire scores and/or 6 min walk test distance.RESULTS: The majority of subjects were men (58%) with a mean (± SD) age of 69±10 years (n=177). Sixty-two per cent of participants had a successful outcome with PR, with proportionally more responders noting subjective improvement than objective improvement on a 6 min walk test (73% versus 51%). Subjects with poor baseline St George’s Respiratory Questionnaire scores tended to improve the most (P=0.011 [ANOVA]). Successful participants had a greater forced expired volume in 1 s (1.1 L versus 0.9 L; P<0.05) and a lower BODE index (body mass index, airflow obstruction, dyspnea, and exercise capacity index) at baseline (9.6 versus 10.3; P<0.05). Success of PR was not correlated with age, sex, chronic hypoxemic respiratory failure or other chronic conditions. Successful participants were more likely to be compliant and to experience fewer adverse events (P≤0.001).CONCLUSIONS: Our study reinforced the belief that the majority of participants with COPD benefit from PR. Few baseline characteristics were predictive of success. Subjectively measured improvement occurred more frequently than objectively measured improvement and was greatest in those with the poorest baseline values.

scholarly journals Serum Surfactant Protein D: Biomarker of Chronic Obstructive Pulmonary Disease

2012 ◽  
Vol 32 (5) ◽  
pp. 281-287 ◽  
Author(s):  
Chun-Rong Ju ◽  
Wei Liu ◽  
Rong-Chang Chen
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Airflow Obstruction ◽  
Surfactant Protein ◽  
Specific Protein ◽  
Surfactant Protein D ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Bode Index ◽  
Severity Of The Disease

Background: Surfactant protein D (SP-D) is a lung-specific protein proposed to predict clinical outcomes in patients with chronic obstructive pulmonary disease (COPD). However, the changes in serum SP-D during acute exacerbation (AECOPD) episodes and the relationship of serum SP-D with the overall severity of the disease in stable COPD (SCOPD) remain unclear.Methods: Serum SP-D levels were analyzed in three groups, including AECOPD (n=40), SCOPD (n=71), and controls (n=60). In AECOPD group, serum SP-D levels were determined at 1, 5, 14, and 30 days post-exacerbation. In SCOPD group, BODE (body mass index, airflow obstruction, dyspnea, exercise capacity) index was evaluated for severity assessment.Results: Serum SP-D levels were sequentially elevated from the controls to the SCOPD, and then to the AECOPD (p< 0.001). During an AECOPD episode, the raised serum SP-D levels subsided at day 5 (p> 0.05), fell markedly at day 14 (p< 0.001), and continued to decline at day 30 (p< 0.001). Among patients with SCOPD, serum SP-D levels correlated positively with the BODE index (p< 0.01).Conclusions: The longitudinal changes in serum SP-D levels during an AECOPD episode suggest that SP-D may be a potential systemic biomarker for COPD exacerbation. The correlation of serum SP-D levels with the BODE index suggests that circulating SP-Ds can reflect the overall severity of SCOPD.

scholarly journals Prognostic Value of C-Reactive Protein, Leukocytes, and Vitamin D in Severe Chronic Obstructive Pulmonary Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Mia Moberg ◽  
Jørgen Vestbo ◽  
Gerd Martinez ◽  
Peter Lange ◽  
Thomas Ringbaek
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Vitamin D ◽  
Pulmonary Disease ◽  
Disease Severity ◽  
Chronic Obstructive ◽  
C Reactive Protein ◽  
Obstructive Pulmonary Disease ◽  
Reactive Protein ◽  
Bode Index ◽  
Severe Copd

Inflammatory biomarkers predict mortality and hospitalisation in chronic obstructive pulmonary disease (COPD). Yet, it remains uncertain if biomarkers in addition to reflecting disease severity add new prognostic information on severe COPD. We investigated if leukocytes, C-reactive protein (CRP), and vitamin D were independent predictors of mortality and hospitalisation after adjusting for disease severity with an integrative index, the i-BODE index. In total, 423 patients participating in a pulmonary rehabilitation programme, with a mean value of FEV1of 38% of predicted, were included. Mean followup was 45 months. During the follow-up period, 149 deaths (35%) were observed and 330 patients (78.0%) had at least one acute hospitalisation; 244 patients (57.7%) had at least one hospitalisation due to an exacerbation of COPD. In the analysis (Cox proportional hazards model) fully adjusted for age, sex, and i-BODE index, the hazard ratio for 1 mg/L increase in CRP was 1.02(P=0.003)and for1×109/Lincrease in leukocytes was 1.43(P=0.03). Only leukocyte count was significantly associated with hospitalisation. Vitamin D was neither associated with mortality nor hospitalisation. Leukocytes and CRP add little information on prognosis and vitamin D does not seem to be a useful biomarker in severe COPD in a clinical setting.

Study of Levels of Plasma Fibrinogen and its Association with Disease Severity in Patients with Chronic Obstructive Pulmonary Disease

2021 ◽  
Vol 15 (11) ◽  
pp. 3403-3405
Author(s):  
Ayesha Masood ◽  
Maria Amin ◽  
Fizza Qasim ◽  
Masroor H. Sharfi
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Elderly Patients ◽  
Pulmonary Disease ◽  
Disease Severity ◽  
Plasma Fibrinogen ◽  
Chronic Obstructive ◽  
P Value ◽  
Obstructive Pulmonary Disease ◽  
Bode Index ◽  
Copd Patients

COPD has been recognized as a component of the systemic inflammatory syndrome. A commonly used indicator of the severity and progression of the disease in COPD is expiratory volume per second (FEV1). However, it is weakly associated with symptoms and administration difficulties in elderly patients. Therefore, there is a need for other markers that are better and easy to apply to sick and elderly patients. Plasma fibrinogen can be used as a marker of disease severity. Aim: To estimate the plasma fibrinogen level in patients with COPD and Relationship of levels of plasma fibrinogen with the severity of chronic obstructive pulmonary disease using the BODE classification and GOLD staging. Place and Duration: In the Medicine Unit-II of Jinnah Hospital Lahore for one-year duration from August 2020 to August 2021. Methods: In this cross-sectional study, 110 COPD patients were assessed by measuring plasma fibrinogen correlated with disease severity using the GOLD scale, BODE index and the 6-minute walk test. Results: Plasma fibrinogen is present in all COPD patients. A significant correlation was observed between the BODE index (r = 0.69, p <0.001), gold grading (r = 0.95, p <0.001) and plasma fibrinogen levels. Most of the 110 subjects (34.5%) were Grade II, then Grade III 30.9%, 18.1% Grade IV and 14.5% Grade I. In our study, it was found that the average level of fibrinogen increased with the increase in the GOLD stage, which was statistically significant, and the p value was 0.01. Conclusions: Plasma fibrinogen levels are significantly higher in COPD and can be used as a marker correlating with disease severity in COPD. Keywords: COPD; plasma fibrinogen; GOLDEN stage; BODE index.

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