title: Predictors of Change in Dyspnea Level in Acute Exacerbations of COPD.
abstract: The aim of this study was to identify factors related to changes in dyspnoea level in the acute and short-term periods after acute exacerbation of chronic obstructive pulmonary disease. This was a prospective cohort study of patients with symptoms of acute chronic obstructive pulmonary disease exacerbation who attended one of 17 hospitals in Spain between June 2008 and September 2010. Clinical data and patient reported measures (dyspnoea level, health-related quality of life, anxiety and depression levels, capacity to perform physical activity) were collected from arrival to the emergency department up to a week after the visit in discharged patients and to discharge in admitted patients (short term). Main outcomes were time course of dyspnoea over the acute (first 24 hours) and short-term periods, mortality and readmission within 2 months of the index episode. Changes in dyspnoea in both periods were related capacity to perform physical activity as well as clinical variables. Short-term changes in dyspnoea were also related to dyspnoea at 24 hours after the ED visit, and anxiety and depression levels. Dyspnoea worsening or failing to improve over the studied periods was associated with poor clinical outcomes. Patient-reported measures are predictive of changes in dyspnoea level.
authors.affiliation: a Research Unit, Health Services Research on Chronic Diseases Network [REDISSEC], Galdakao-Usansolo Hospital [Osakidetza] Galdakao , Bizkaia , Spain.
authors.forename: Susana
authors.initials: S
authors.lastname: Garcia-Gutierrez
authors.affiliation: a Research Unit, Health Services Research on Chronic Diseases Network [REDISSEC], Galdakao-Usansolo Hospital [Osakidetza] Galdakao , Bizkaia , Spain.
authors.forename: José M
authors.initials: JM
authors.lastname: Quintana
authors.affiliation: a Research Unit, Health Services Research on Chronic Diseases Network [REDISSEC], Galdakao-Usansolo Hospital [Osakidetza] Galdakao , Bizkaia , Spain.
authors.forename: Anette
authors.initials: A
authors.lastname: Unzurrunzaga
authors.affiliation: b Respiratory Department, Health Services Research on Chronic Diseases Network [REDISSEC], Galdakao-Usansolo Hospital [Osakidetza] , Galdakao , Bizkaia , Spain.
authors.forename: Cristóbal
authors.initials: C
authors.lastname: Esteban
authors.affiliation: c Clinical Epidemiology Unit, Health Services Research on Chronic Diseases Network [REDISSEC], Corporacio Parc Tauli , Barcelona , Spain.
authors.forename: Marisa
authors.initials: M
authors.lastname: Baré
authors.affiliation: d Agencia Lain Entralgo, Health Services Research on Chronic Diseases Network [REDISSEC] , Madrid , Spain.
authors.forename: Nerea
authors.initials: N
authors.lastname: Fernández de Larrea
authors.affiliation: e Emergency Department, Galdakao-Usansolo Hospital , Galdakao , Bizkaia , Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: Pulido
authors.affiliation: f Research Unit, Health Services Research on Chronic Diseases Network [REDISSEC] , Hospital Costa del Sol , Marbella , Málaga.
authors.forename: Paco
authors.initials: P
authors.lastname: Rivas
authors.affiliation: f Research Unit, Health Services Research on Chronic Diseases Network [REDISSEC] , Hospital Costa del Sol , Marbella , Málaga.
authors.forename: Iryss
authors.initials: I
authors.lastname: -Copd Group
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000523:psychology; D003863:Depression / Q000523:psychology; D018450:Disease Progression; D004417:Dyspnea / Q000209:etiology*; D017079:Exercise Tolerance; D005260:Female; D005541:Forced Expiratory Volume; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000401:mortality / Q000503:physiopathology*; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: outcomes assessment; patient-reported outcomes; prognosis; shortness of breath