Abebaw Mengistu Yohannes1, Hana Mülerová2, Kim Lavoie3, Jorgen Vestbo4, Steve I Rennard5, Emile Wouters6, Nicola A Hanania7. 1. Department of Health Professions, Manchester Metropolitan University, Manchester, UK. Electronic address: ayohannes@apu.edu. 2. Respiratory Epidemiology, GlaxoSmithKine R&D, Uxbridge, UK. 3. Department of Psychology-University of Quebec at Montreal, Montreal, Quebec, Canada. 4. Division of Infection, Immunity, and Respiratory Medicine, Manchester Academic Health Science Centre, University of Manchester and University Hospital South Manchester NHS Foundation Trust, Manchester, UK. 5. University of Nebraska Medical Center, Omaha, NE; Clinical Discovery Unit, Early Clinical Development, AstraZeneca, Cambridge, UK. 6. Program Development Centre, CIRO+, Centre of Expertise for Chronic Organ Failure, Horn, Netherlands; Department of Respiratory Medicine, Maastricht UMC+, Maastricht, Netherlands. 7. Section of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, TX.
Abstract
BACKGROUND: Depression increases disability and health care utilization in older patients with chronic obstructive pulmonary disease (COPD). OBJECTIVES: To determine contribution of depressive symptoms to the incidence of moderate-severe and severe acute exacerbations of COPD (AECOPD) over 3 years. DESIGN: We analyzed data collected from a prospective cohort of patients with COPD (Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints; ECLIPSE). SETTING: Multicentered outpatient. PARTICIPANTS: A total of 2059 patients with COPD with complete data (63.7% men, mean age 63.4 + 7.1 years). MEASUREMENTS: Depression was assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). Moderate-severe AECOPDs were collected; a subset of very severe AECOPD was defined as requiring hospital admission. RESULTS: A total of 540 (26%) patients with COPD reported high depressive symptoms (CES-D ≥16). High depressive symptoms at baseline related to an increased risk of moderate-severe and severe AECOPD during the follow-up (odds ratio [OR] 1.18; 95% confidence interval [CI] 1.07-1.30; for moderate-severe and OR 1.36; 95% CI 1.09-1.69 for severe events risk of hospitalizations) independent of key covariates of an AECOPD history before recruitment in the study, history of gastroesophageal reflux, baseline severity of airflow limitation, and white blood cell count that were also associated with an increased risk of moderate to severe exacerbations (all P < .001). CONCLUSION: Presence of high depressive symptoms at baseline were associated with subsequent moderate-severe exacerbations and hospital admissions in patients with COPD over 3 years, independent of a history of exacerbations and other demographic and clinical factors. Targeted personalized medicine that focuses both on AECOPD risk and depression may be a step forward to improving prognosis of patients with COPD.
BACKGROUND:Depression increases disability and health care utilization in older patients with chronic obstructive pulmonary disease (COPD). OBJECTIVES: To determine contribution of depressive symptoms to the incidence of moderate-severe and severe acute exacerbations of COPD (AECOPD) over 3 years. DESIGN: We analyzed data collected from a prospective cohort of patients with COPD (Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints; ECLIPSE). SETTING: Multicentered outpatient. PARTICIPANTS: A total of 2059 patients with COPD with complete data (63.7% men, mean age 63.4 + 7.1 years). MEASUREMENTS: Depression was assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). Moderate-severe AECOPDs were collected; a subset of very severe AECOPD was defined as requiring hospital admission. RESULTS: A total of 540 (26%) patients with COPD reported high depressive symptoms (CES-D ≥16). High depressive symptoms at baseline related to an increased risk of moderate-severe and severe AECOPD during the follow-up (odds ratio [OR] 1.18; 95% confidence interval [CI] 1.07-1.30; for moderate-severe and OR 1.36; 95% CI 1.09-1.69 for severe events risk of hospitalizations) independent of key covariates of an AECOPD history before recruitment in the study, history of gastroesophageal reflux, baseline severity of airflow limitation, and white blood cell count that were also associated with an increased risk of moderate to severe exacerbations (all P < .001). CONCLUSION: Presence of high depressive symptoms at baseline were associated with subsequent moderate-severe exacerbations and hospital admissions in patients with COPD over 3 years, independent of a history of exacerbations and other demographic and clinical factors. Targeted personalized medicine that focuses both on AECOPD risk and depression may be a step forward to improving prognosis of patients with COPD.
Authors: Thomas Keller; Laura J Spece; Lucas M Donovan; Edmunds Udris; Scott S Coggeshall; Matthew Griffith; Alexander D Bryant; Richard Casaburi; J Allen Cooper; Gerard J Criner; Philip T Diaz; Anne L Fuhlbrigge; Steven E Gay; Richard E Kanner; Fernando J Martinez; Ralph J Panos; David Shade; Alice Sternberg; Thomas Stibolt; James K Stoller; James Tonascia; Robert Wise; Roger D Yusen; David H Au; Laura C Feemster Journal: Chest Date: 2020-04-09 Impact factor: 9.410
Authors: Jacqueline O'Toole; Han Woo; Nirupama Putcha; Christopher B Cooper; Prescott Woodruff; Richard E Kanner; Robert Paine; Russell P Bowler; Alejandro Comellas; Karin F Hoth; Jerry A Krishnan; Meilan Han; Mark Dransfield; Anand S Iyer; David Couper; Stephen P Peters; Gerard Criner; Victor Kim; R Graham Barr; Fernando J Martinez; Nadia N Hansel; Michelle N Eakin Journal: Ann Am Thorac Soc Date: 2022-02
Authors: Aliza A Panjwani; Joel Erblich; Tracey A Revenson; Hoda J Badr; Alex D Federman; Juan P Wisnivesky Journal: Psychol Health Med Date: 2022-04-03 Impact factor: 3.898
Authors: John R Hurst; MeiLan K Han; Barinder Singh; Sakshi Sharma; Gagandeep Kaur; Enrico de Nigris; Ulf Holmgren; Mohd Kashif Siddiqui Journal: Respir Res Date: 2022-08-23
Authors: Marieann Högman; Johanna Sulku; Björn Ställberg; Christer Janson; Kristina Bröms; Hans Hedenström; Karin Lisspers; Andrei Malinovschi Journal: Int J Chron Obstruct Pulmon Dis Date: 2018-01-03