RT Journal Article
SR Electronic
T1 The impact of depressive symptoms on recovery and outcome of hospitalised COPD exacerbations
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 815
OP 823
DO 10.1183/09031936.00013112
VO 41
IS 4
A1 Andriana I. Papaioannou
A1 Konstantinos Bartziokas
A1 Stamatoula Tsikrika
A1 Foteini Karakontaki
A1 Emmanouil Kastanakis
A1 Winston Banya
A1 Aikaterini Haniotou
A1 Spyros Papiris
A1 Stelios Loukides
A1 Vlassis Polychronopoulos
A1 Konstantinos Kostikas
YR 2013
UL http://erj.ersjournals.com/content/41/4/815.abstract
AB The impact of depressive symptoms on outcomes of acute exacerbations of chronic obstructive pulmonary disease (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. Pulmonary function tests, arterial blood gases, COPD assessment test (CAT) and Borg dyspnoea scale were recorded on admission and on days 3, 10 and 40. Patients were evaluated monthly for 1 year. Patients with depressive symptoms required longer hospitalisation (mean±sd 11.6±3.7 versus 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 hospitalisations for AECOPD (p<0.001) in 1 year. In multivariate analysis, depressive symptoms were an independent predictor of mortality (hazard ratio 3.568, 95% CI 1.302–9.780) and risk for AECOPD (incidence rate ratio (IRR) 2.221, 95% CI 1.573–3.135) and AECOPD hospitalisations (IRR 3.589, 95% CI 2.319–5.556) in 1 year. The presence of depressive symptoms in patients admitted for AECOPD has a significant impact on recovery and is related to worse survival and increased risk for subsequent COPD exacerbations and hospitalisations in 1 year.