Extra-pulmonary features in COPD patients entering rehabilitation after stratification for MRC dyspnea grade

被引:65
作者
Spruit, Martijn A. [1 ]
Pennings, Herman-Jan
Janssen, Paul P.
Does, Joan D.
Scroyen, Sigrid
Akkermans, Marco A.
Mostert, Rob
Wouters, Emiel F. M.
机构
[1] Ctr Integrated Rehabil Organ Failure, Dept Res Dev & Educ, Horn, Netherlands
[2] Ctr Integrated Rehabil Organ Failure, Dept Resp Med, Horn, Netherlands
[3] Ctr Integrated Rehabil Organ Failure, Dept Physiotherapy, Horn, Netherlands
[4] Univ Hosp Maastricht, Dept Resp Med, Maastricht, Netherlands
关键词
COPD; medical research; council; Dyspnea; disease-specific health status; body composition; exercise intolerance;
D O I
10.1016/j.rmed.2007.07.003
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Experts have stated that referral for rehabilitation of patients with chronic obstructive pulmonary disease (COPD) becomes appropriate when these patients become aware of their disability (e.g. usually grade 3 to 5 on the Medical Research Council (MRC) dyspnea scale). However, patients with MRC dyspnea grade 1/2 may also suffer from extra-pulmonary features, such as abnormal body composition, exercise intolerance and reduced disease -specific health status. In the present study, we have studied whether and to what extent chronic obstructive pulmonary disease (COPD) patients with MRC dyspnea grade 1/2 have extra-pulmonary features compared to patients with grade 3, 4 or 5? Pulmonary function, body composition, 6-min walking distance, peak exercise capacity, anxiety, depression and disease-specific health status have been assessed in 333 outpatients who had been referred for pulmonary rehabilitation. On average, patients with MRC dyspnea grade 1/2 had a better exercise tolerance and disease-specific health status compared to patients with grade 4 or 5. Nevertheless, grade 1/2 patients had a higher prevalence of muscle mass depletion. In addition, these patients did still have aberrant values in one or more of the aforementioned outcomes. On average, patients with MRC dyspnea grade 1/2 may clearly suffer from extra-pulmonary features, indicating the necessity to refer these patients for rehabilitation. Therefore, MRC dyspnea scale alone does not appear to be a suitable measure to identify most patients with COPD who have to be referred for rehabilitation. (C) 2007 Elsevier Ltd. All rights reserved.
引用
收藏
页码:2454 / 2463
页数:10
相关论文
共 63 条
[1]   STATISTICAL GUIDELINES FOR CONTRIBUTORS TO MEDICAL JOURNALS [J].
ALTMAN, DG ;
GORE, SM ;
GARDNER, MJ ;
POCOCK, SJ .
BRITISH MEDICAL JOURNAL, 1983, 286 (6376) :1489-1493
[2]  
[Anonymous], 1990, Med Sci Sports Exerc, V22, P265
[3]   Sustained improvements in dyspnea and pulmonary function 3 to 5 years after lung volume reduction surgery [J].
Appleton, S ;
Adams, R ;
Porter, S ;
Peacock, M ;
Ruffin, R .
CHEST, 2003, 123 (06) :1838-1846
[5]  
Berner Y N, 2001, Age Ageing, V30, P530, DOI 10.1093/ageing/30.6.530
[6]   Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease [J].
Bestall, JC ;
Paul, EA ;
Garrod, R ;
Garnham, R ;
Jones, PW ;
Wedzicha, JA .
THORAX, 1999, 54 (07) :581-586
[7]  
BROEKHUIZEN R, 2005, THORAX
[8]   The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease [J].
Celli, BR ;
Cote, CG ;
Marin, JM ;
Casanova, C ;
de Oca, MM ;
Mendez, RA ;
Pinto Plata, V ;
Cabral, HJ .
NEW ENGLAND JOURNAL OF MEDICINE, 2004, 350 (10) :1005-1012
[9]   A NEW METHOD OF CLASSIFYING PROGNOSTIC CO-MORBIDITY IN LONGITUDINAL-STUDIES - DEVELOPMENT AND VALIDATION [J].
CHARLSON, ME ;
POMPEI, P ;
ALES, KL ;
MACKENZIE, CR .
JOURNAL OF CHRONIC DISEASES, 1987, 40 (05) :373-383
[10]   ATS statement: Guidelines for the six-minute walk test [J].
Crapo, RO ;
Casaburi, R ;
Coates, AL ;
Enright, PL ;
MacIntyre, NR ;
McKay, RT ;
Johnson, D ;
Wanger, JS ;
Zeballos, RJ ;
Bittner, V ;
Mottram, C .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2002, 166 (01) :111-117