Abstract
The impact of depressive symptoms on outcomes of acute exacerbations of COPD (AECOPD) has not been thoroughly evaluated in prospective studies.
We prospectively enrolled 230 consecutive patients hospitalised for AECOPD, without previous diagnosis of depression. Depressive symptoms were evaluated with Beck's Depression Inventory (BDI). Pulmonary function tests, arterial blood gases, COPD assessment test (CAT) and Borg dyspnoea scale were recorded on admission and days 3, 10 and 40. Patients were evaluated monthly for one year.
Patients with depressive symptoms required longer hospitalization [11.6±3.7 vs. 5.6±4.1 days, p<0.001]. Clinical variables improved during the course of AECOPD, but depressive symptoms on admission had a significant impact on dyspnoea (p<0.001) and CAT score (p=0.012) improvement. Patients with depressive symptoms presented more AECOPD (p<0.001) and more hospitalizations for AECOPD (p<0.001) in 1-year. In multivariate analysis, depressive symptoms were an independent predictor of mortality [hazard ratio, HR 3.568 (95%CI: 1.302–9.780)] and risk for AECOPD [incidence rate ratio, IRR 2.221 (1.573–3.135)] and AECOPD hospitalizations [IRR 3.589 (2.319–5.556)] in 1-year.
The presence of depressive symptomsin patients admitted for AECOPD has a significant impact on recovery and is related to worse survival and increased risk for subsequent COPD exacerbations and hospitalizations in one year.
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