Chest
Clinical InvestigationsMeasurement of Short-term Changes in Dyspnea and Disease-Specific Quality of Life Following an Acute COPD Exacerbation
Section snippets
Patients
Patients with an acute COPD exacerbation (characterized by increased chronic baseline dyspnea, increased sputum volume, and/or increased sputum purulence)15 were recruited to the study from four Eastern Ontario emergency departments (EDs) during the winter months from January 1998 to March 2000. Inclusion criteria for entry included: (1) a previous diagnosis of COPD, (2) FEV1 ≤ 70% of predicted and an FEV1/FVC ratio ≤ 70% in the ED, (3) evidence of chronic airflow obstruction (obtained at a
Results
Seventy patients with acute COPD exacerbation were recruited into the study on initial presentation to the ED. Of these 70 patients, 66 patients completed the initial and day-10 follow-up assessments. Four patients did not complete the study: one patient dropped out of the study on day 3, one patient was unavailable for follow-up until day 17, and two patients returned for reassessment on day 10 but refused to complete the day-10 CRQ and TDI.
Baseline characteristics of the 70 enrolled patients
Discussion
This study has been successful in documenting short-term changes in disease-specific QOL and dyspnea that occur immediately following acute COPD exacerbation. Our study demonstrates that most patients experience significant improvements in QOL and dyspnea following 10 days of medical therapy for an acute COPD exacerbation. However, this study has also shown that there exists a subset of outpatients whose dyspnea and QOL clearly do not improve, and that these are the patients who seek further
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2023, Respiratory Medicine and ResearchAssessment of dyspnea in sarcoidosis using the Baseline Dyspnea Index (BDI) and the Transition Dyspnea Index (TDI)
2022, Respiratory MedicineCitation Excerpt :Changes in dyspnea from baseline on each of the three components (TDI) are rated on a seven-point scale from −3 (major deterioration) to +3 (major improvement) for a TDI_Total score of −9 to +9 [21]. BDI-TDI scores have been validated for the measurement of dyspnea and change in dyspnea over time in COPD patients and have been shown to correlate with measures of health-related quality of life (HRQoL) in that population [23–30]. A 1-unit change in TDI has been determined to be the minimum clinically important difference (MCID) in TDI for COPD patients [25,26].
Impact of COPD exacerbations leading to hospitalization on general and disease-specific quality of life
2021, Respiratory MedicineCitation Excerpt :Hospitalized patients may be hospitalized in part due to more severe disease, as characterized by more severe obstruction, more impaired gas exchange, increased muscle weakness [11], and increased anxiety and social isolation compared to those not hospitalized [12–15]. Short term improvements in disease-specific quality of life and dyspnea over the course of hospitalization, however, have been noted in a previous single center study [16]. The overall impact on general and health-related quality of life of a hospitalized exacerbation, rather than one in a patient who is not hospitalized, is unknown.
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2015, American Journal of MedicineAssessment of dyspnoea in the emergency department by numeric and visual scales: A pilot study
2015, Anaesthesia Critical Care and Pain MedicineCitation Excerpt :In our health-care system, increasing pressure on emergency departments (EDs) to limit costs and waiting times has resulted in the development of many clinical decision aids and admission prediction tools designed to assist physicians in meeting these demands. However, most of these tools are disease specific [8,9] and none are currently available for application to patients presenting to the ED with shortness of breath. Although somewhat limited, current evidence supports the utilization of a simple dyspnoea rating scale, to assist in the evaluation of clinical severity, and to potentially provide useful information to facilitate rapid and accurate site-of-care decisions in this setting [10].
Determinants of gait speed in COPD
2014, ChestCitation Excerpt :Dyspnea was measured with the modified Medical Research Council (mMRC) dyspnea scale.20,21 Quality of life was measured with the disease-specific Chronic Respiratory Questionnaire (CRQ)22 and a generic tool, the Linear Analog Self-Assessment-6 questionnaire (Likert scales evaluating well-being in six domains: overall quality of life, physical, mental, emotional, social activity, and spiritual).23 We measured depressive symptoms with the Patient Health Questionnaire-2, a validated two-item questionnaire.24
Supported by grant 13098 from the Ontario Emergency Health Services Research Fund and by grant MCT-41545 from the Canadian Institutes of Health Research.