Frailty in Chronic Obstructive Pulmonary Disease and Risk of Exacerbations and Hospitalizations
| Autor: | Kenneth C. Pike, Nathan Yee, Vincent S. Fan, Huong Q. Nguyen, Joe C Huang, Emily Locke, Zijing Chen, Jung-Eun Lee |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Weakness COPD business.industry Frailty syndrome Low activity Pulmonary disease General Medicine medicine.disease respiratory tract diseases 03 medical and health sciences Malnutrition 0302 clinical medicine 030228 respiratory system Internal medicine Cohort medicine Population study 030212 general & internal medicine medicine.symptom business |
| Zdroj: | International Journal of Chronic Obstructive Pulmonary Disease. 15:1967-1976 |
| ISSN: | 1178-2005 |
| Popis: | Background Frailty is a complex clinical syndrome associated with vulnerability to adverse health outcomes. While frailty is thought to be common in chronic obstructive pulmonary disease (COPD), the relationship between frailty and COPD-related outcomes such as risk of acute exacerbations of COPD (AE-COPD) and hospitalizations is unclear. Purpose To examine the association between physical frailty and risk of acute exacerbations, hospitalizations, and mortality in patients with COPD. Methods A longitudinal analysis of data from a cohort of 280 participants was performed. Baseline frailty measures included exhaustion, weakness, low activity, slowness, and undernutrition. Outcome measures included AE-COPD, hospitalizations, and mortality over 2 years. Negative binomial regression and Cox proportional hazard modeling were used. Results Sixty-two percent of the study population met criteria for pre-frail and 23% were frail. In adjusted analyses, the frailty syndrome was not associated with COPD exacerbations. However, among the individual components of the frailty syndrome, weakness measured by handgrip strength was associated with increased risk of COPD exacerbations (IRR 1.46, 95% CI 1.09-1.97). The frailty phenotype was not associated with all-cause hospitalizations but was associated with increased risk of non-COPD-related hospitalizations. Conclusion This longitudinal cohort study shows that a high proportion of patients with COPD are pre-frail or frail. The frailty phenotype was associated with an increased risk of non-COPD hospitalizations but not with all-cause hospitalizations or COPD exacerbations. Among the individual frailty components, low handgrip strength was associated with increased risk of COPD exacerbations over a 2-year period. Measuring handgrip strength may identify COPD patients who could benefit from programs to reduce COPD exacerbations. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|