Discriminative and predictive properties of disease-specific and generic health status indexes in elderly COPD patients
<p>Abstract</p> <p>Background</p> <p>The association between bronchial obstruction severity and mortality in Chronic Obstructive Pulmonary Disease (COPD) is well established, but it is unknown whether disease-specific health status measures and multidimensional assessme...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2008-08-01
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| Series: | BMC Pulmonary Medicine |
| Online Access: | http://www.biomedcentral.com/1471-2466/8/14 |
| _version_ | 1818766294582820864 |
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| author | Forastiere Francesco Bellia Vincenzo Pedone Claudio Conte Maria E Antonelli-Incalzi Raffaele |
| author_facet | Forastiere Francesco Bellia Vincenzo Pedone Claudio Conte Maria E Antonelli-Incalzi Raffaele |
| author_sort | Forastiere Francesco |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>The association between bronchial obstruction severity and mortality in Chronic Obstructive Pulmonary Disease (COPD) is well established, but it is unknown whether disease-specific health status measures and multidimensional assessment (MDA) have comparable prognostic value.</p> <p>Methods</p> <p>We analyzed data coming from the Salute Respiratoria nell'Anziano (Respiratory Health in the Elderly – SaRA) study, enrolling elderly people attending outpatient clinics for respiratory and non-respiratory problems. From this population we selected 449 patients with bronchial obstruction (77.3% men, mean age 73.1). We classified patients' health status using tertiles of the Saint George Respiratory Questionnaire (SGRQ) and a MDA including functional (the 6' walking test, WT), cognitive (Mini-Mental State Examination, MMSE) and affective status (Geriatric Depression Scale, GDS). The agreement of the classification methods was calculated using the kappa statistic, and survival associated with group membership was evaluated using survival analysis.</p> <p>Results</p> <p>Pulmonary function, expressed by the FEV1, worsened with increasing SGRQ or MDA scores. Cognitive function was not associated with the SGRQ, while physical performance and mood status were impaired only in the highest tertile of SGRQ. A poor agreement was found between the two classification systems tested (k = 0.194). Compared to people in the first tertile of SGRQ score, those in the second tertile had a sex-adjusted HR of 1.22 (0.75 – 1.98) and those in the third tertile of 2.90 (1.92 – 4.40). The corresponding figures of the MDA were 1.49 (95% CI 1.02 – 2.18) and 2.01 (95% CI: 1.31 – 3.08). After adjustment for severity of obstruction, only a SGRQ in the upper tertile was associated with mortality (HR: 1.86; 95% CI: 1.14 – 3.02).</p> <p>Conclusion</p> <p>In elderly outpatients with mild-moderate COPD, a disease-specific health status index seems to be a better predictor of death compared to a MDA.</p> |
| first_indexed | 2024-12-18T08:31:42Z |
| format | Article |
| id | doaj.art-23723710d9084b9f8a62b76a7310aee4 |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-12-18T08:31:42Z |
| publishDate | 2008-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-23723710d9084b9f8a62b76a7310aee42022-12-21T21:14:26ZengBMCBMC Pulmonary Medicine1471-24662008-08-01811410.1186/1471-2466-8-14Discriminative and predictive properties of disease-specific and generic health status indexes in elderly COPD patientsForastiere FrancescoBellia VincenzoPedone ClaudioConte Maria EAntonelli-Incalzi Raffaele<p>Abstract</p> <p>Background</p> <p>The association between bronchial obstruction severity and mortality in Chronic Obstructive Pulmonary Disease (COPD) is well established, but it is unknown whether disease-specific health status measures and multidimensional assessment (MDA) have comparable prognostic value.</p> <p>Methods</p> <p>We analyzed data coming from the Salute Respiratoria nell'Anziano (Respiratory Health in the Elderly – SaRA) study, enrolling elderly people attending outpatient clinics for respiratory and non-respiratory problems. From this population we selected 449 patients with bronchial obstruction (77.3% men, mean age 73.1). We classified patients' health status using tertiles of the Saint George Respiratory Questionnaire (SGRQ) and a MDA including functional (the 6' walking test, WT), cognitive (Mini-Mental State Examination, MMSE) and affective status (Geriatric Depression Scale, GDS). The agreement of the classification methods was calculated using the kappa statistic, and survival associated with group membership was evaluated using survival analysis.</p> <p>Results</p> <p>Pulmonary function, expressed by the FEV1, worsened with increasing SGRQ or MDA scores. Cognitive function was not associated with the SGRQ, while physical performance and mood status were impaired only in the highest tertile of SGRQ. A poor agreement was found between the two classification systems tested (k = 0.194). Compared to people in the first tertile of SGRQ score, those in the second tertile had a sex-adjusted HR of 1.22 (0.75 – 1.98) and those in the third tertile of 2.90 (1.92 – 4.40). The corresponding figures of the MDA were 1.49 (95% CI 1.02 – 2.18) and 2.01 (95% CI: 1.31 – 3.08). After adjustment for severity of obstruction, only a SGRQ in the upper tertile was associated with mortality (HR: 1.86; 95% CI: 1.14 – 3.02).</p> <p>Conclusion</p> <p>In elderly outpatients with mild-moderate COPD, a disease-specific health status index seems to be a better predictor of death compared to a MDA.</p>http://www.biomedcentral.com/1471-2466/8/14 |
| spellingShingle | Forastiere Francesco Bellia Vincenzo Pedone Claudio Conte Maria E Antonelli-Incalzi Raffaele Discriminative and predictive properties of disease-specific and generic health status indexes in elderly COPD patients BMC Pulmonary Medicine |
| title | Discriminative and predictive properties of disease-specific and generic health status indexes in elderly COPD patients |
| title_full | Discriminative and predictive properties of disease-specific and generic health status indexes in elderly COPD patients |
| title_fullStr | Discriminative and predictive properties of disease-specific and generic health status indexes in elderly COPD patients |
| title_full_unstemmed | Discriminative and predictive properties of disease-specific and generic health status indexes in elderly COPD patients |
| title_short | Discriminative and predictive properties of disease-specific and generic health status indexes in elderly COPD patients |
| title_sort | discriminative and predictive properties of disease specific and generic health status indexes in elderly copd patients |
| url | http://www.biomedcentral.com/1471-2466/8/14 |
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