Marc Miravitlles1, Ana Menezes2, Maria Victorina López Varela3, Alejandro Casas4, Luis Ugalde5, Alejandra Ramirez-Venegas6, Laura Mendoza7, Ana López8, Fernando C Wehrmeister2, Filip Surmont9, Maria Montes de Oca10. 1. Department of Pneumology, Hospital Universitari Vall d'Hebron, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain. Electronic address: mmiravitlles@vhebron.net. 2. Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil. 3. Universidad de la República, Montevideo, Uruguay. 4. Fundación Neumológica Colombiana, Universidad del Rosario, Bogotá, Colombia. 5. Clínica Americana, San José, Costa Rica. 6. Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México, Mexico. 7. Hospital Clínico Universidad de Chile, Santiago de Chile, Chile. 8. Hospital Privado Universitario de Córdoba, Córdoba, Argentina. 9. AstraZeneca, Wilmington, USA. 10. Hospital Universitario de Caracas, Universidad Central de Venezuela, Caracas, Venezuela.
Abstract
BACKGROUND: To analyse the relationship between symptoms at different times during the 24-hour day and outcomes in COPD. METHODS: Observational cross-sectional study in a patients from 7 Latin American countries. The frequency of symptoms in the morning, at night and during the day was explored by means of standardised and validated questionnaires, and the relationship between symptoms and exacerbations and quality of life were investigated. RESULTS: 734 patients (59.6% male, mean age 69.5 years, mean FEV1 50% predicted normal) were recruited. The most frequent symptoms during the day were dyspnea (75% of patients, of which 94% mild-moderate) and cough (72.2%, of which 93.4% mild-moderate). Highly symptomatic patients had a greater impairment in FEV1, more exacerbations and worse scores in COPD assessment test (CAT) and Body Mass Index, Obstruction, Dyspnoea and Exacerbations (BODEx) index (all p < 0.001). Morning symptoms were more frequent than night-time symptoms, particularly cough and dyspnoea (morning: 50.1% and 45.7%; night-time: 33.2% and 24.4%, respectively), and mostly rated as mild or moderate. Patients with morning or night-time symptoms presented with worse severity of daytime symptoms. There was a strong correlation between intensity of daytime with morning or night-time symptoms, as well as with CAT score (r = 0.715; p < 0.001), but a weak correlation with FEV1 (r = -0.205; p < 0.001). CONCLUSION: Morning symptoms were more frequent than night-time symptoms, and having either morning and/or night-time symptoms was associated with worse severity of daytime symptoms. Increased symptoms were strongly associated with worse quality of life and more frequent exacerbations, but weakly associated with airflow limitation. CLINICAL TRIAL REGISTRATION: NCT02789540.
BACKGROUND: To analyse the relationship between symptoms at different times during the 24-hour day and outcomes in COPD. METHODS: Observational cross-sectional study in a patients from 7 Latin American countries. The frequency of symptoms in the morning, at night and during the day was explored by means of standardised and validated questionnaires, and the relationship between symptoms and exacerbations and quality of life were investigated. RESULTS: 734 patients (59.6% male, mean age 69.5 years, mean FEV1 50% predicted normal) were recruited. The most frequent symptoms during the day were dyspnea (75% of patients, of which 94% mild-moderate) and cough (72.2%, of which 93.4% mild-moderate). Highly symptomatic patients had a greater impairment in FEV1, more exacerbations and worse scores in COPD assessment test (CAT) and Body Mass Index, Obstruction, Dyspnoea and Exacerbations (BODEx) index (all p < 0.001). Morning symptoms were more frequent than night-time symptoms, particularly cough and dyspnoea (morning: 50.1% and 45.7%; night-time: 33.2% and 24.4%, respectively), and mostly rated as mild or moderate. Patients with morning or night-time symptoms presented with worse severity of daytime symptoms. There was a strong correlation between intensity of daytime with morning or night-time symptoms, as well as with CAT score (r = 0.715; p < 0.001), but a weak correlation with FEV1 (r = -0.205; p < 0.001). CONCLUSION: Morning symptoms were more frequent than night-time symptoms, and having either morning and/or night-time symptoms was associated with worse severity of daytime symptoms. Increased symptoms were strongly associated with worse quality of life and more frequent exacerbations, but weakly associated with airflow limitation. CLINICAL TRIAL REGISTRATION: NCT02789540.
Authors: Alejandro Casas; Maria Montes de Oca; Ana Mb Menezes; Fernando C Wehrmeister; Maria Victorina Lopez Varela; Laura Mendoza; Larissa Ramírez; Marc Miravitlles Journal: Int J Chron Obstruct Pulmon Dis Date: 2018-05-11
Authors: Kate M Johnson; Abdollah Safari; Wan C Tan; Jean Bourbeau; J Mark FitzGerald; Mohsen Sadatsafavi; On Behalf Of The Canadian Cohort Of Obstructive Lung Disease CanCOLD Study Journal: Int J Chron Obstruct Pulmon Dis Date: 2018-12-13
Authors: Alberto Cukier; Irma de Godoy; Claudia Henrique da Costa; Adalberto Sperb Rubin; Marcelo Gervilla Gregorio; Aldo Agra de Albuquerque Neto; Marina Andrade Lima; Monica Corso Pereira; Suzana Erico Tanni; Rodrigo Abensur Athanazio; Elizabeth Jauhar Cardoso Bessa; Fernando Cesar Wehrmeister; Cristina Bassi Lourenco; Ana Maria Baptista Menezes Journal: J Bras Pneumol Date: 2019-12-20 Impact factor: 2.624