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1 Dept of Respiratory Medicine, Allergy and Sleep, Landspitali University Hospital, Reykjavik, Iceland. 2 Dept of Medical Sciences, Respiratory Medicine and Allergology, Uppsala University, Akademiska Sjukhuset, Uppsala, Sweden. 3 Dept of Respiratory Diseases, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark. 4 Dept of Respiratory Medicine, Tampere University Hospital, Tampere, Finland. 5 Haukeland University Hospital, Bergen, Norway.
CORRESPONDENCE: G. Gudmundsson, Dept of Respiratory Medicine, Allergy and Sleep, Landspitali University Hospital, E-7 Fossvogur, IS-108 Reykjavik, Iceland. Fax: 354 5436568. E-mail: ggudmund@landspitali.is
Keywords: Anxiety, chronic obstructive pulmonary disease, depression, health status, rehospitalisation, risk factors
Received: June 29, 2004
Accepted April 30, 2005
The aim of the present study was to analyse the risk of rehospitalisation in patients with chronic obstructive pulmonary disease and associated risk factors.
This prospective study included 416 patients from a university hospital in each of the five Nordic countries. Data included demographic information, spirometry, comorbidity and 12 month follow-up for 406 patients. The hospital anxiety and depression scale and St. George's Respiratory Questionnaire (SGRQ) were applied to all patients.
The number of patients that had a re-admission within 12 months was 246 (60.6%). Patients that had a re-admission had lower lung function and health status. A low forced expiratory volume in one second (FEV1) and health status were independent predictors for re-admission. Hazard ratio (HR; 95% CI) was 0.82 (0.74–0.90) per 10% increase of the predicted FEV1 and 1.06 (1.02–1.10) per 4 units increase in total SGRQ score. The risk of rehospitalisation was also increased in subjects with anxiety (HR 1.76 (1.16–2.68)) and in subjects with low health status (total SGRQ score >60 units). When comparing the different subscales in the SGRQ, the closest relation between the risk of rehospitalisation was seen with the activity scale (HR 1.07 (1.03–1.11) per 4 unit increase).
In patients with low health status, anxiety is an important risk factor for rehospitalisation. This may be important for patient treatment and warrants further studies.
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