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Titolo:
CHANGES IN DYSPNEA, HEALTH-STATUS, AND LUNG-FUNCTION IN CHRONIC AIRWAY DISEASE
Autore:
MAHLER DA; TOMLINSON D; OLMSTEAD EM; TOSTESON ANA; OCONNOR GT;
Indirizzi:
DARTMOUTH COLL SCH MED,DEPT MED,PULM & CRIT CARE MED SECT,3-D LEBANONNH 03756 DARTMOUTH COLL SCH MED,DEPT COMMUNITY & FAMILY MED LEBANON NH 03756
Titolo Testata:
American journal of respiratory and critical care medicine
fascicolo: 1, volume: 151, anno: 1995,
pagine: 61 - 65
SICI:
1073-449X(1995)151:1<61:CIDHAL>2.0.ZU;2-D
Fonte:
ISI
Lingua:
ENG
Soggetto:
OBSTRUCTIVE PULMONARY-DISEASE; QUALITY-OF-LIFE; FLOW LIMITATION; REDUCES DYSPNEA; OUTCOMES; POPULATION; MANAGEMENT; PROGNOSIS; VALIDITY; IMPACT;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
33
Recensione:
Indirizzi per estratti:
Citazione:
D.A. Mahler et al., "CHANGES IN DYSPNEA, HEALTH-STATUS, AND LUNG-FUNCTION IN CHRONIC AIRWAY DISEASE", American journal of respiratory and critical care medicine, 151(1), 1995, pp. 61-65

Abstract

The purpose of this study was to examine longitudinal changes in clinical parameters in patients with chronic obstructive pulmonary disease(COPD). We postulated that progressive dyspnea and decline in lung function over time would influence or impact patient's health status. Clinical ratings of dyspnea, general health status, and physiologic lungfunction were measured every 6 mo over a 2-yr period in an original group of 110 male patients with stable but symptomatic COPD and no significant comorbidity. At enrollment, age was 67 +/- 8 yr(mean +/- SD), forced expiratory volume in one second (FEV(1)) was 1.28 +/- 0.59 l (44 +/- 17% of predicted), and forced vital capacity (FVC) was 2.84 +/- 0.84 l (68 +/- 18% of predicted). A total of 34 patients ''dropped out'' because of death (n = 20), relocation (n = 7), and other reasons (n= 7). Dyspnea was measured using the transition dyspnea index (TDI), which represented changes from the baseline state; general health status was measured using the Medical Outcomes Study (MOS) 20-item short-form survey; physiologic lung function was assessed by spirometry (FVC and FEV(1)) and inspiratory muscle strength (P-lmax) Statistical analyses were performed using all available data for each patient, including results until the time at which patients died or were lost to follow-up. Repeated measures analysis of covariance showed there were significant decreases in the TDI focal score (-0.7 +/- 2.9; p = 0.04), P-lmax (from 59.0 +/- 25.0 to 55.6 +/- 26.2 cm H2O; p < 0.001), and physical functioning score of the MOS survey (from 32.7 +/- 26.4 to 25.7 +/- 27.2; p < 0.001) over the 2-yr period. Although changes were also noted for FVC (p < 0.02) and FEV(1) (p < 0.02), these measures did not increase or decrease consistently over time. The five other health components of the MOS showed no significant change over time. The changes indyspnea were significantly related to changes in lung function. Regression analysis revealed that the TDI focal score was a significant predictor for all components of general health; status whereas FEV(1) wasa significant predictor of five of the six components of health. We conclude that dyspnea, P-lmax, and physical functioning decline over 2 yr in a cohort of patients with symptomatic COPD Both dyspnea ratings and lung function, particularly FEV(1), were significant predictors ofvarious components; of general health status. It is possible that physical functioning is the initial health component to. decline in patients with COPD, whereas a longer time period may be required to demonstrate changes, in other components. Alternatively, patients with COPD may adapt to deterioration in dyspnea and physiologic function by adjusting their lifestyle to maintain role and social functioning, mental health, and health: perceptions and minimize pain.

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Documento generato il 15/07/20 alle ore 21:03:56