Anxiety is associated with diminished exercise performance and quality of life in severe emphysema: a cross-sectional study

被引:57
作者
Giardino, Nicholas D. [1 ,3 ]
Curtis, Jeffrey L. [2 ,4 ]
Andrei, Adin-Cristian [2 ]
Fan, Vincent S. [5 ]
Benditt, Joshua O. [5 ]
Lyubkin, Mark [1 ,3 ]
Naunheim, Keith [6 ]
Criner, Gerard [7 ]
Make, Barry [8 ,9 ]
Wise, Robert A. [10 ]
Murray, Susan K. [2 ]
Fishman, Alfred P. [11 ]
Sciurba, Frank C. [12 ]
Liberzon, Israel [1 ,3 ]
Martinez, Fernando J. [2 ]
机构
[1] VA Ann Arbor Healthcare Syst, Mental Hlth Serv, Ann Arbor, MI USA
[2] Univ Michigan Hlth Syst, Div Pulm & Crit Care Med, Dept Internal Med, Ann Arbor, MI USA
[3] Univ Michigan, Dept Psychiat, Ann Arbor, MI 48109 USA
[4] VA Ann Arbor Healthcare Syst, Pulm & Crit Care Med Sect, Ann Arbor, MI USA
[5] Univ Washington, Div Pulm & Crit Care Med, Seattle, WA 98195 USA
[6] St Louis Univ, Dept Surg, St Louis, MO USA
[7] Temple Univ, Div Pulm & Crit Care Med, Philadelphia, PA 19122 USA
[8] Univ Colorado, Div Pulm Sci & Crit Care Med, Natl Jewish Med Ctr, Denver, CO USA
[9] Univ Colorado, Res Ctr, Denver, CO USA
[10] Johns Hopkins Univ, Div Pulm & Crit Care Med, Baltimore, MD USA
[11] Univ Penn, Dept Med, Philadelphia, PA 19104 USA
[12] Univ Pittsburgh, Div Pulm & Crit Care Med, Pittsburgh, PA USA
基金
美国医疗保健研究与质量局;
关键词
OBSTRUCTIVE PULMONARY-DISEASE; HEALTH-STATUS; PSYCHOLOGICAL OUTCOMES; FUNCTIONAL STATUS; RANDOMIZED-TRIAL; COMORBID ANXIETY; COPD PATIENTS; DEPRESSION; PREVALENCE; SYMPTOMS;
D O I
10.1186/1465-9921-11-29
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
100201 [内科学];
摘要
Background: Anxiety in patients with chronic obstructive pulmonary disease (COPD) is associated with self-reported disability. The purpose of this study is to determine whether there is an association between anxiety and functional measures, quality of life and dyspnea. Methods: Data from 1828 patients with moderate to severe emphysema enrolled in the National Emphysema Treatment Trial (NETT), collected prior to rehabilitation and randomization, were used in linear regression models to test the association between anxiety symptoms, measured by the Spielberger State Trait Anxiety Inventory (STAI) and: (a) six-minute walk distance test (6 MWD), (b) cycle ergometry peak workload, (c) St. Georges Respiratory Questionnaire (SRGQ), and (d) UCSD Shortness of Breath Questionnaire (SOBQ), after controlling for potential confounders including age, gender, FEV1 (% predicted), DLCO (% predicted), and the Beck Depression Inventory (BDI). Results: Anxiety was significantly associated with worse functional capacity [ 6 MWD (B = -0.944, p < .001), ergometry peak workload (B = -.087, p = .04)], quality of life (B = .172, p < .001) and shortness of breath (B = .180, p < .001). Regression coefficients show that a 10 point increase in anxiety score is associated with a mean decrease in 6 MWD of 9 meters, a 1 Watt decrease in peak exercise workload, and an increase of almost 2 points on both the SGRQ and SOBQ. Conclusion: In clinically stable patients with moderate to severe emphysema, anxiety is associated with worse exercise performance, quality of life and shortness of breath, after accounting for the influence of demographic and physiologic factors known to affect these outcomes.
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页数:11
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