One-year change in health status and subsequent outcomes in COPD

Sarah Wilke; Paul W Jones; H Müllerova; Jørgen Vestbo; Ruth Tal-Singer; Frits M E Franssen; Alvar Agusti; Per Bakke; Peter M Calverley; Harvey O Coxson; Courtney Crim; Lisa D Edwards; David A Lomas; William MacNee; Stephen I Rennard; Julie C Yates; Emiel F M Wouters; Martijn A Spruit

doi:10.1136/thoraxjnl-2014-205697

One-year change in health status and subsequent outcomes in COPD

Sarah Wilke
, Paul W Jones
, H Müllerova
, Jørgen Vestbo
, Ruth Tal-Singer
, Frits M E Franssen
, Alvar Agusti
, Per Bakke
, Peter M Calverley
, Harvey O Coxson
, Courtney Crim
, Lisa D Edwards
, David A Lomas
, William MacNee
, Stephen I Rennard
, Julie C Yates
, Emiel F M Wouters
, Martijn A Spruit

Lungesygdomme HGH

50 Citationer (Scopus)

Abstract

BACKGROUND: Poor health status has been associated with morbidity and mortality in patients with COPD. To date, the impact of changes in health status on these outcomes remains unknown.

AIMS: To explore the relationship of clinically relevant changes in health status with exacerbation, hospitalisation or death in patients with COPD.

METHODS: Characteristics and health status (St George's Respiratory Questionnaire, SGRQ) were assessed over a period of 3 years in 2138 patients with COPD enrolled in the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study: a longitudinal, prospective, observational study. Associations between change in health status (=4 units in SGRQ score) during year 1 and time to first exacerbation, hospitalisation and death during 2-year follow-up were assessed using Kaplan-Meier plots and log-rank test.

RESULTS: 1832 (85.7%) patients (age 63.4±7.0 years, 65.4% male, FEV1 48.7±15.6% predicted) underwent assessment at baseline and 1 year. Compared with those who deteriorated, patients with improved or stable health status in year 1 have a lower likelihood of exacerbation (HR 0.78 (95% CI 0.67 to 0.89), p<0.001 and 0.84 (0.73 to 0.97), p=0.016, respectively), hospitalisation (0.72 (0.58 to 0.90), p=0.004 and 0.77 (0.62 to 0.96), p=0.023, respectively) or dying (0.61 (0.39 to 0.95), p=0.027 and 0.58 (0.37 to 0.92), p=0.019, respectively) during 2-year follow-up. This effect persisted after stratification for age and the number of exacerbations and hospitalisations during the first year of the study.

CONCLUSIONS: Patients with stable or improved health status during year 1 of ECLIPSE had a lower likelihood of exacerbation, hospitalisation or dying during 2-year follow-up. Interventions that stabilise and improve health status may also improve outcomes in patients with COPD.

TRIAL REGISTRATION NUMBER: NCT00292552, registered at ClinicalTrials.gov.

Originalsprog	Engelsk
Tidsskrift	Thorax
Vol/bind	70
Udgave nummer	5
Sider (fra-til)	420-5
Antal sider	6
ISSN	0040-6376
DOI	https://doi.org/10.1136/thoraxjnl-2014-205697
Status	Udgivet - maj 2015

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10.1136/thoraxjnl-2014-205697

Citationsformater

Wilke, S., Jones, P. W., Müllerova, H., Vestbo, J., Tal-Singer, R., Franssen, F. M. E., Agusti, A., Bakke, P., Calverley, P. M., Coxson, H. O., Crim, C., Edwards, L. D., Lomas, D. A., MacNee, W., Rennard, S. I., Yates, J. C., Wouters, E. F. M., & Spruit, M. A. (2015). One-year change in health status and subsequent outcomes in COPD. Thorax, 70(5), 420-5. https://doi.org/10.1136/thoraxjnl-2014-205697

Wilke, S, Jones, PW, Müllerova, H, Vestbo, J, Tal-Singer, R, Franssen, FME, Agusti, A, Bakke, P, Calverley, PM, Coxson, HO, Crim, C, Edwards, LD, Lomas, DA, MacNee, W, Rennard, SI, Yates, JC, Wouters, EFM & Spruit, MA 2015, 'One-year change in health status and subsequent outcomes in COPD', Thorax, bind 70, nr. 5, s. 420-5. https://doi.org/10.1136/thoraxjnl-2014-205697

@article{4a7a9c29b932457a9b24301c00b6709b,

title = "One-year change in health status and subsequent outcomes in COPD",

abstract = "BACKGROUND: Poor health status has been associated with morbidity and mortality in patients with COPD. To date, the impact of changes in health status on these outcomes remains unknown.AIMS: To explore the relationship of clinically relevant changes in health status with exacerbation, hospitalisation or death in patients with COPD.METHODS: Characteristics and health status (St George's Respiratory Questionnaire, SGRQ) were assessed over a period of 3 years in 2138 patients with COPD enrolled in the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study: a longitudinal, prospective, observational study. Associations between change in health status (=4 units in SGRQ score) during year 1 and time to first exacerbation, hospitalisation and death during 2-year follow-up were assessed using Kaplan-Meier plots and log-rank test.RESULTS: 1832 (85.7\%) patients (age 63.4±7.0 years, 65.4\% male, FEV1 48.7±15.6\% predicted) underwent assessment at baseline and 1 year. Compared with those who deteriorated, patients with improved or stable health status in year 1 have a lower likelihood of exacerbation (HR 0.78 (95\% CI 0.67 to 0.89), p<0.001 and 0.84 (0.73 to 0.97), p=0.016, respectively), hospitalisation (0.72 (0.58 to 0.90), p=0.004 and 0.77 (0.62 to 0.96), p=0.023, respectively) or dying (0.61 (0.39 to 0.95), p=0.027 and 0.58 (0.37 to 0.92), p=0.019, respectively) during 2-year follow-up. This effect persisted after stratification for age and the number of exacerbations and hospitalisations during the first year of the study.CONCLUSIONS: Patients with stable or improved health status during year 1 of ECLIPSE had a lower likelihood of exacerbation, hospitalisation or dying during 2-year follow-up. Interventions that stabilise and improve health status may also improve outcomes in patients with COPD.TRIAL REGISTRATION NUMBER: NCT00292552, registered at ClinicalTrials.gov.",

keywords = "Adult, Aged, Female, Forced Expiratory Volume, Health Status, Hospitalization, Humans, Longitudinal Studies, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, Pulmonary Disease, Chronic Obstructive, Surveys and Questionnaires, Time Factors",

author = "Sarah Wilke and Jones, \{Paul W\} and H M{\"u}llerova and J{\o}rgen Vestbo and Ruth Tal-Singer and Franssen, \{Frits M E\} and Alvar Agusti and Per Bakke and Calverley, \{Peter M\} and Coxson, \{Harvey O\} and Courtney Crim and Edwards, \{Lisa D\} and Lomas, \{David A\} and William MacNee and Rennard, \{Stephen I\} and Yates, \{Julie C\} and Wouters, \{Emiel F M\} and Spruit, \{Martijn A\}",

note = "Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.",

year = "2015",

month = may,

doi = "10.1136/thoraxjnl-2014-205697",

language = "English",

volume = "70",

pages = "420--5",

journal = "Thorax",

issn = "0040-6376",

publisher = "BMJ Publishing Group",

number = "5",

}

TY - JOUR

T1 - One-year change in health status and subsequent outcomes in COPD

AU - Wilke, Sarah

AU - Jones, Paul W

AU - Müllerova, H

AU - Vestbo, Jørgen

AU - Tal-Singer, Ruth

AU - Franssen, Frits M E

AU - Agusti, Alvar

AU - Bakke, Per

AU - Calverley, Peter M

AU - Coxson, Harvey O

AU - Crim, Courtney

AU - Edwards, Lisa D

AU - Lomas, David A

AU - MacNee, William

AU - Rennard, Stephen I

AU - Yates, Julie C

AU - Wouters, Emiel F M

AU - Spruit, Martijn A

N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

PY - 2015/5

Y1 - 2015/5

N2 - BACKGROUND: Poor health status has been associated with morbidity and mortality in patients with COPD. To date, the impact of changes in health status on these outcomes remains unknown.AIMS: To explore the relationship of clinically relevant changes in health status with exacerbation, hospitalisation or death in patients with COPD.METHODS: Characteristics and health status (St George's Respiratory Questionnaire, SGRQ) were assessed over a period of 3 years in 2138 patients with COPD enrolled in the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study: a longitudinal, prospective, observational study. Associations between change in health status (=4 units in SGRQ score) during year 1 and time to first exacerbation, hospitalisation and death during 2-year follow-up were assessed using Kaplan-Meier plots and log-rank test.RESULTS: 1832 (85.7%) patients (age 63.4±7.0 years, 65.4% male, FEV1 48.7±15.6% predicted) underwent assessment at baseline and 1 year. Compared with those who deteriorated, patients with improved or stable health status in year 1 have a lower likelihood of exacerbation (HR 0.78 (95% CI 0.67 to 0.89), p<0.001 and 0.84 (0.73 to 0.97), p=0.016, respectively), hospitalisation (0.72 (0.58 to 0.90), p=0.004 and 0.77 (0.62 to 0.96), p=0.023, respectively) or dying (0.61 (0.39 to 0.95), p=0.027 and 0.58 (0.37 to 0.92), p=0.019, respectively) during 2-year follow-up. This effect persisted after stratification for age and the number of exacerbations and hospitalisations during the first year of the study.CONCLUSIONS: Patients with stable or improved health status during year 1 of ECLIPSE had a lower likelihood of exacerbation, hospitalisation or dying during 2-year follow-up. Interventions that stabilise and improve health status may also improve outcomes in patients with COPD.TRIAL REGISTRATION NUMBER: NCT00292552, registered at ClinicalTrials.gov.

AB - BACKGROUND: Poor health status has been associated with morbidity and mortality in patients with COPD. To date, the impact of changes in health status on these outcomes remains unknown.AIMS: To explore the relationship of clinically relevant changes in health status with exacerbation, hospitalisation or death in patients with COPD.METHODS: Characteristics and health status (St George's Respiratory Questionnaire, SGRQ) were assessed over a period of 3 years in 2138 patients with COPD enrolled in the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study: a longitudinal, prospective, observational study. Associations between change in health status (=4 units in SGRQ score) during year 1 and time to first exacerbation, hospitalisation and death during 2-year follow-up were assessed using Kaplan-Meier plots and log-rank test.RESULTS: 1832 (85.7%) patients (age 63.4±7.0 years, 65.4% male, FEV1 48.7±15.6% predicted) underwent assessment at baseline and 1 year. Compared with those who deteriorated, patients with improved or stable health status in year 1 have a lower likelihood of exacerbation (HR 0.78 (95% CI 0.67 to 0.89), p<0.001 and 0.84 (0.73 to 0.97), p=0.016, respectively), hospitalisation (0.72 (0.58 to 0.90), p=0.004 and 0.77 (0.62 to 0.96), p=0.023, respectively) or dying (0.61 (0.39 to 0.95), p=0.027 and 0.58 (0.37 to 0.92), p=0.019, respectively) during 2-year follow-up. This effect persisted after stratification for age and the number of exacerbations and hospitalisations during the first year of the study.CONCLUSIONS: Patients with stable or improved health status during year 1 of ECLIPSE had a lower likelihood of exacerbation, hospitalisation or dying during 2-year follow-up. Interventions that stabilise and improve health status may also improve outcomes in patients with COPD.TRIAL REGISTRATION NUMBER: NCT00292552, registered at ClinicalTrials.gov.

KW - Adult

KW - Aged

KW - Female

KW - Forced Expiratory Volume

KW - Health Status

KW - Hospitalization

KW - Humans

KW - Longitudinal Studies

KW - Male

KW - Middle Aged

KW - Predictive Value of Tests

KW - Prospective Studies

KW - Pulmonary Disease, Chronic Obstructive

KW - Surveys and Questionnaires

KW - Time Factors

U2 - 10.1136/thoraxjnl-2014-205697

DO - 10.1136/thoraxjnl-2014-205697

M3 - Journal article

C2 - 25782757

SN - 0040-6376

VL - 70

SP - 420

EP - 425

JO - Thorax

JF - Thorax

IS - 5

ER -

One-year change in health status and subsequent outcomes in COPD

Abstract

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