One-year change in health status and subsequent outcomes in COPD

Sarah Wilke, Paul W. Jones, H. Müllerova, Jørgen Vestbo, Ruth Tal-Singer, Frits M.E. Franssen, Alvar Agusti, Per Bakke, Peter M. Calverley, Harvey O. Coxson, Courtney Crim, Lisa D. Edwards, David A. Lomas, William MacNee, Stephen I. Rennard, Julie C. Yates, Emiel F.M. Wouters, Martijn A. Spruit

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background: Poor health status has been associated with morbidity and mortality in patients with COPD. To date, the impact of changes in health status on these outcomes remains unknown. Aims: To explore the relationship of clinically relevant changes in health status with exacerbation, hospitalisation or death in patients with COPD. Methods: Characteristics and health status (St George's Respiratory Questionnaire, SGRQ) were assessed over a period of 3 years in 2138 patients with COPD enrolled in the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study: a longitudinal, prospective, observational study. Associations between change in health status (=4 units in SGRQ score) during year 1 and time to first exacerbation, hospitalisation and death during 2-year follow-up were assessed using Kaplan-Meier plots and log-rank test. Results: 1832 (85.7%) patients (age 63.4±7.0 years, 65.4% male, FEV1 48.7±15.6% predicted) underwent assessment at baseline and 1 year. Compared with those who deteriorated, patients with improved or stable health status in year 1 have a lower likelihood of exacerbation (HR 0.78 (95% CI 0.67 to 0.89), p<0.001 and 0.84 (0.73 to 0.97), p=0.016, respectively), hospitalisation (0.72 (0.58 to 0.90), p=0.004 and 0.77 (0.62 to 0.96), p=0.023, respectively) or dying (0.61 (0.39 to 0.95), p=0.027 and 0.58 (0.37 to 0.92), p=0.019, respectively) during 2-year follow-up. This effect persisted after stratification for age and the number of exacerbations and hospitalisations during the first year of the study. Conclusions: Patients with stable or improved health status during year 1 of ECLIPSE had a lower likelihood of exacerbation, hospitalisation or dying during 2-year follow-up. Interventions that stabilise and improve health status may also improve outcomes in patients with COPD.

Original languageEnglish (US)
Pages (from-to)420-425
Number of pages6
JournalThorax
Volume70
Issue number5
DOIs
StatePublished - May 1 2015

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Chronic Obstructive Pulmonary Disease
Health Status
Hospitalization
Biomarkers
Observational Studies
Longitudinal Studies
Prospective Studies
Morbidity
Mortality

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Wilke, S., Jones, P. W., Müllerova, H., Vestbo, J., Tal-Singer, R., Franssen, F. M. E., ... Spruit, M. A. (2015). One-year change in health status and subsequent outcomes in COPD. Thorax, 70(5), 420-425. https://doi.org/10.1136/thoraxjnl-2014-205697

One-year change in health status and subsequent outcomes in COPD. / Wilke, Sarah; Jones, Paul W.; Müllerova, H.; Vestbo, Jørgen; Tal-Singer, Ruth; Franssen, Frits M.E.; Agusti, Alvar; Bakke, Per; Calverley, Peter M.; Coxson, Harvey O.; Crim, Courtney; Edwards, Lisa D.; Lomas, David A.; MacNee, William; Rennard, Stephen I.; Yates, Julie C.; Wouters, Emiel F.M.; Spruit, Martijn A.

In: Thorax, Vol. 70, No. 5, 01.05.2015, p. 420-425.

Research output: Contribution to journalArticle

Wilke, S, Jones, PW, Müllerova, H, Vestbo, J, Tal-Singer, R, Franssen, FME, Agusti, A, Bakke, P, Calverley, PM, Coxson, HO, Crim, C, Edwards, LD, Lomas, DA, MacNee, W, Rennard, SI, Yates, JC, Wouters, EFM & Spruit, MA 2015, 'One-year change in health status and subsequent outcomes in COPD', Thorax, vol. 70, no. 5, pp. 420-425. https://doi.org/10.1136/thoraxjnl-2014-205697
Wilke S, Jones PW, Müllerova H, Vestbo J, Tal-Singer R, Franssen FME et al. One-year change in health status and subsequent outcomes in COPD. Thorax. 2015 May 1;70(5):420-425. https://doi.org/10.1136/thoraxjnl-2014-205697
Wilke, Sarah ; Jones, Paul W. ; Müllerova, H. ; Vestbo, Jørgen ; Tal-Singer, Ruth ; Franssen, Frits M.E. ; Agusti, Alvar ; Bakke, Per ; Calverley, Peter M. ; Coxson, Harvey O. ; Crim, Courtney ; Edwards, Lisa D. ; Lomas, David A. ; MacNee, William ; Rennard, Stephen I. ; Yates, Julie C. ; Wouters, Emiel F.M. ; Spruit, Martijn A. / One-year change in health status and subsequent outcomes in COPD. In: Thorax. 2015 ; Vol. 70, No. 5. pp. 420-425.
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abstract = "Background: Poor health status has been associated with morbidity and mortality in patients with COPD. To date, the impact of changes in health status on these outcomes remains unknown. Aims: To explore the relationship of clinically relevant changes in health status with exacerbation, hospitalisation or death in patients with COPD. Methods: Characteristics and health status (St George's Respiratory Questionnaire, SGRQ) were assessed over a period of 3 years in 2138 patients with COPD enrolled in the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study: a longitudinal, prospective, observational study. Associations between change in health status (=4 units in SGRQ score) during year 1 and time to first exacerbation, hospitalisation and death during 2-year follow-up were assessed using Kaplan-Meier plots and log-rank test. Results: 1832 (85.7{\%}) patients (age 63.4±7.0 years, 65.4{\%} male, FEV1 48.7±15.6{\%} predicted) underwent assessment at baseline and 1 year. Compared with those who deteriorated, patients with improved or stable health status in year 1 have a lower likelihood of exacerbation (HR 0.78 (95{\%} CI 0.67 to 0.89), p<0.001 and 0.84 (0.73 to 0.97), p=0.016, respectively), hospitalisation (0.72 (0.58 to 0.90), p=0.004 and 0.77 (0.62 to 0.96), p=0.023, respectively) or dying (0.61 (0.39 to 0.95), p=0.027 and 0.58 (0.37 to 0.92), p=0.019, respectively) during 2-year follow-up. This effect persisted after stratification for age and the number of exacerbations and hospitalisations during the first year of the study. Conclusions: Patients with stable or improved health status during year 1 of ECLIPSE had a lower likelihood of exacerbation, hospitalisation or dying during 2-year follow-up. Interventions that stabilise and improve health status may also improve outcomes in patients with COPD.",
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T1 - One-year change in health status and subsequent outcomes in COPD

AU - Wilke, Sarah

AU - Jones, Paul W.

AU - Müllerova, H.

AU - Vestbo, Jørgen

AU - Tal-Singer, Ruth

AU - Franssen, Frits M.E.

AU - Agusti, Alvar

AU - Bakke, Per

AU - Calverley, Peter M.

AU - Coxson, Harvey O.

AU - Crim, Courtney

AU - Edwards, Lisa D.

AU - Lomas, David A.

AU - MacNee, William

AU - Rennard, Stephen I.

AU - Yates, Julie C.

AU - Wouters, Emiel F.M.

AU - Spruit, Martijn A.

PY - 2015/5/1

Y1 - 2015/5/1

N2 - Background: Poor health status has been associated with morbidity and mortality in patients with COPD. To date, the impact of changes in health status on these outcomes remains unknown. Aims: To explore the relationship of clinically relevant changes in health status with exacerbation, hospitalisation or death in patients with COPD. Methods: Characteristics and health status (St George's Respiratory Questionnaire, SGRQ) were assessed over a period of 3 years in 2138 patients with COPD enrolled in the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study: a longitudinal, prospective, observational study. Associations between change in health status (=4 units in SGRQ score) during year 1 and time to first exacerbation, hospitalisation and death during 2-year follow-up were assessed using Kaplan-Meier plots and log-rank test. Results: 1832 (85.7%) patients (age 63.4±7.0 years, 65.4% male, FEV1 48.7±15.6% predicted) underwent assessment at baseline and 1 year. Compared with those who deteriorated, patients with improved or stable health status in year 1 have a lower likelihood of exacerbation (HR 0.78 (95% CI 0.67 to 0.89), p<0.001 and 0.84 (0.73 to 0.97), p=0.016, respectively), hospitalisation (0.72 (0.58 to 0.90), p=0.004 and 0.77 (0.62 to 0.96), p=0.023, respectively) or dying (0.61 (0.39 to 0.95), p=0.027 and 0.58 (0.37 to 0.92), p=0.019, respectively) during 2-year follow-up. This effect persisted after stratification for age and the number of exacerbations and hospitalisations during the first year of the study. Conclusions: Patients with stable or improved health status during year 1 of ECLIPSE had a lower likelihood of exacerbation, hospitalisation or dying during 2-year follow-up. Interventions that stabilise and improve health status may also improve outcomes in patients with COPD.

AB - Background: Poor health status has been associated with morbidity and mortality in patients with COPD. To date, the impact of changes in health status on these outcomes remains unknown. Aims: To explore the relationship of clinically relevant changes in health status with exacerbation, hospitalisation or death in patients with COPD. Methods: Characteristics and health status (St George's Respiratory Questionnaire, SGRQ) were assessed over a period of 3 years in 2138 patients with COPD enrolled in the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study: a longitudinal, prospective, observational study. Associations between change in health status (=4 units in SGRQ score) during year 1 and time to first exacerbation, hospitalisation and death during 2-year follow-up were assessed using Kaplan-Meier plots and log-rank test. Results: 1832 (85.7%) patients (age 63.4±7.0 years, 65.4% male, FEV1 48.7±15.6% predicted) underwent assessment at baseline and 1 year. Compared with those who deteriorated, patients with improved or stable health status in year 1 have a lower likelihood of exacerbation (HR 0.78 (95% CI 0.67 to 0.89), p<0.001 and 0.84 (0.73 to 0.97), p=0.016, respectively), hospitalisation (0.72 (0.58 to 0.90), p=0.004 and 0.77 (0.62 to 0.96), p=0.023, respectively) or dying (0.61 (0.39 to 0.95), p=0.027 and 0.58 (0.37 to 0.92), p=0.019, respectively) during 2-year follow-up. This effect persisted after stratification for age and the number of exacerbations and hospitalisations during the first year of the study. Conclusions: Patients with stable or improved health status during year 1 of ECLIPSE had a lower likelihood of exacerbation, hospitalisation or dying during 2-year follow-up. Interventions that stabilise and improve health status may also improve outcomes in patients with COPD.

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