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The variability of respiratory symptoms and associated factors in COPD - 26/07/17

Doi : 10.1016/j.rmed.2017.06.017 
Marc Miravitlles a, b, , José Luis Izquierdo c, Cristina Esquinas a, Maite Pérez d, Myriam Calle e, José Luis López-Campos b, f, José Miguel Rodríguez González-Moro g, Ciro Casanova h, Cristóbal Esteban i, Pilar de Lucas j
a Pneumology Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain 
b CIBER de Enfermedades Respiratorias (CIBERES), Spain 
c Hospital Universitario de Guadalajara, Guadalajara, Spain 
d Medical Department, AstraZeneca Farmacéutica, Barcelona, Spain 
e Pulmonary Department, Hospital Clínico San Carlos, Department of Medicine, Faculty of Medicine, University Complutense of Madrid, Research Institute of Hospital Clínico San Carlos (IdISSC), Madrid, Spain 
f Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocio/ Universidad de Sevilla, Spain 
g Servicio de Neumología, Hospital Universitario Principe de Asturias, Alcalá de Henares, Madrid, Spain 
h Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain 
i Servicio de Neumologia, Hospital Galdakao-Usansolo, Galdakao, Spain, Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Spain 
j Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Madrid, Spain 

Corresponding author. Pneumology Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain.Pneumology DepartmentHospital Universitari Vall d’HebronBarcelonaSpain

Abstract

Few studies have investigated the variability of COPD-related symptoms or factors related to symptom variability.

This observational, prospective, multicentre study was conducted to describe the number and intensity of morning and night-time respiratory symptoms and their variability over one week using the Night-time and Early Morning Symptoms of COPD Instruments (NiSCI and EMSCI) to evaluate stable COPD patients. Logistic regression analyses were performed to investigate factors associated with symptom variability.

A total of 2669 patients were evaluated (mean age, 67.7 years; 80.9% men; mean FEV1 50.6%). Of these, 48% reported night-time symptoms and 71% reported morning symptoms. Of the 2293 patients who completed the NiSCI and EMSCI, 90% showed variability in either symptom number (89.6%) or symptom intensity (15.8%). More severe dyspnoea, more exacerbations during the previous year and the exacerbator or mixed COPD-asthma phenotypes were associated with variability in symptom number or intensity. Anxiety was significantly associated with variability in symptom number and intensity.

Most COPD patients showed symptom variability over a weeklong period, especially in terms of symptom number. Several COPD-related factors, mainly factors related to more severe disease and more frequent exacerbations, were associated with increased symptom variability.

El texto completo de este artículo está disponible en PDF.

Highlights

48% of patients reported night-time symptoms and 71% reported morning symptoms.
There is a high variability in number and intensity of symptoms over a week.
Dyspnea, exacerbations and asthma-COPD are associated with variability of symptoms.

El texto completo de este artículo está disponible en PDF.

Keywords : COPD, Symptoms, Variability, Quality of life, Sleep


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Vol 129

P. 165-172 - août 2017 Regresar al número
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