Carlos Martinez Rivera1, Joaquín Costan Galicia2, Bernardino Alcázar Navarrete3, Cayo Garcia-Polo4, Luis Alberto Ruiz Iturriaga5, Alberto Herrejón6, Jose Antonio Ros Lucas7, Patricia García-Sidro8, Gema Tirado-Conde9, Jose Luis López-Campos10, Sagrario Mayoralas Alises11, Javier de Miguel-Díez12, Cristina Esquinas13, Marc Miravitlles13. 1. Pneumology Service, University Hospital Germans Trias i Pujol, Ctra. Canyet s/n, 08916, Badalona, Spain. carlosmartinezrivera.cmr@gmail.com. 2. Clínico Lozano Blesa Hospital, Saragossa, Spain. 3. Alta Resolución Hospital, Loja, Granada, Spain. 4. Unit of Clinical Management of Pneumology, Puerta del Mar Hospital, Cádiz, Spain. 5. University Hospital of Cruces, Vizcaya, Spain. 6. Dr. Pesset Hospital, Valencia, Spain. 7. Virgen de Arrixaca Hospital, Murcia, Spain. 8. University Hospital de La Plana, Vilarreal, Spain. 9. University Hospital Puerto Real, Cádiz, Spain. 10. Medical-Surgical Unit of Respiratory Diseases Virgen del Rocio University Hospital, Biomedicine Institute of Seville (IBiS), Seville, Spain. 11. Ramón y Cajal Hospital, Madrid, Spain. 12. Pneumology Department, Hospital Gregorio Marañon, Madrid, Spain. 13. Pneumology Department, Vall d'Hebron University Hospital, CIBER de Enfermedades Respiratorias (CIBERS), Barcelona, Spain.
Abstract
INTRODUCTION: Depression is a prevalent comorbidity in COPD and has an impact on the prognosis of these patients, thereby making it important to study the factors associated with depression in patients with COPD. METHOD: A multicenter, observational and cross-sectional study was conducted to study the factors associated with depression in patients with COPD measured by the hospital anxiety and depression (HAD) questionnaire. We analyzed anthropometric variables and the number of exacerbations in the previous year and calculated the 6-min walking test and the body mass index, airflow obstruction, dyspnea, and exercise (BODE) index. All the patients completed the quality of life EQ-5D and the LCADL physical activity questionnaires. The relationship of these variables with depression was evaluated with two multiple logistic regression models. RESULTS: One hundred fifteen patients were evaluated (93 % male) with a mean age of 66.9 years (SD 8.8) and a mean FEV1 % of 44.4 % (SD 15.7 %). 24.3 % presented symptoms of depression (HAD-D > 8). These latter patients had worse lung function, greater dyspnea, reduced exercise capacity, a higher score in the BODE index, poorer quality of life, reduced physical activity, and more exacerbations. In the first logistic regression model, quality of life and the BODE index were associated with depression (AUC: 0.84; 0.74-0.94). In the second model including the variables in the BODE index, quality of life and dyspnea measured with the MRC scale (AUC: 0.87; 0.79-0.95) were associated with depression. CONCLUSIONS: Nearly one-quarter of the patients with COPD in this study presented clinically significant depression associated with worse quality of life, reduced exercise capacity, greater dyspnea, and a higher score in the BODE index.
INTRODUCTION:Depression is a prevalent comorbidity in COPD and has an impact on the prognosis of these patients, thereby making it important to study the factors associated with depression in patients with COPD. METHOD: A multicenter, observational and cross-sectional study was conducted to study the factors associated with depression in patients with COPD measured by the hospital anxiety and depression (HAD) questionnaire. We analyzed anthropometric variables and the number of exacerbations in the previous year and calculated the 6-min walking test and the body mass index, airflow obstruction, dyspnea, and exercise (BODE) index. All the patients completed the quality of life EQ-5D and the LCADL physical activity questionnaires. The relationship of these variables with depression was evaluated with two multiple logistic regression models. RESULTS: One hundred fifteen patients were evaluated (93 % male) with a mean age of 66.9 years (SD 8.8) and a mean FEV1 % of 44.4 % (SD 15.7 %). 24.3 % presented symptoms of depression (HAD-D > 8). These latter patientshad worse lung function, greater dyspnea, reduced exercise capacity, a higher score in the BODE index, poorer quality of life, reduced physical activity, and more exacerbations. In the first logistic regression model, quality of life and the BODE index were associated with depression (AUC: 0.84; 0.74-0.94). In the second model including the variables in the BODE index, quality of life and dyspnea measured with the MRC scale (AUC: 0.87; 0.79-0.95) were associated with depression. CONCLUSIONS: Nearly one-quarter of the patients with COPD in this study presented clinically significant depression associated with worse quality of life, reduced exercise capacity, greater dyspnea, and a higher score in the BODE index.
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Authors: Cristina Esquinas; Maria A Ramon; Alexa Nuñez; Jesús Molina; José A Quintano; Miguel Roman-Rodríguez; Karlos Naberan; Carl Llor; Carlos Roncero; Marc Miravitlles; Miriam Barrecheguren Journal: Qual Life Res Date: 2019-10-31 Impact factor: 4.147
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