Revista Portuguesa de Pneumologia
versão impressa ISSN 0873-2159
CARNEIRO, Rui et al. Risk factors for readmission after hospital discharge in chronic obstructive pulmonary disease: The role of quality of life indicators. Rev Port Pneumol [online]. 2010, vol.16, n.5, pp. 759-777. ISSN 0873-2159.
Aims: To identify demographic, clinical, functional and inherent quality of life (QOL) and depression factors with impact on use of the Emergency Services (ES) or readmission after hospital discharge for acute exacerbation of chronic obstructive pulmonary disease (COPD) over a period of 66 weeks. QOL was evaluated by the St. Georges Respiratory Questionnaire (SGRQ). The Beck Depression Inventory assessed depression. We prospectively evaluated 45 patients (84.4% male, median age 73 years, stage IV 51%). The median total SGRQ score was 50.6, with a greater impact on symptoms, especially in younger patients (r=-0.425; p=0.043), and activity limitation than emotional impact of the disease. More than half were depressed. Worse QOL meant depression (R=0.699; p=0.02). Low FEV1 correlated with depression (r=-0.46; p=0.05) but not with QOL. Long-acting anti-cholinergic bronchodilator and inhaled steroids improved QOL. Almost 85% of patients used ES (25.8% for exacerbated COPD). Rate of hospital readmission for all reasons and exacerbated COPD was 64.9% and 33.3%. The number of readmissions (all reasons) was correlated with age (R=0.48; p=0003), cor pulmonale (R=-0.46; p=0.03) and QOL (R=0.67; p=0.004). Depressed patients (R=0.51; p=004), with low FEV1 (R=-0413; p=0.04) and with cor pulmonale (R=-046, p=0.005) had more inhospital days for exacerbation of COPD. QOL and depression are variables to consider in the evaluation and treatment of patients with COPD as part of a set of clinical and functional data that can predict the risk of readmission after hospital discharge for exacerbated COPD.
Palavras-chave : Chronic obstructive pulmonary disease; quality of life; depression; admission to hospital.