アブストラクト | BACKGROUND & AIMS: Breathlessness is a primary clinical feature of chronic obstructive pulmonary disease (COPD). We aimed to describe the frequency of and factors associated with breathlessness in a cohort of COPD patients identified from the Clinical Practice Research Datalink (CPRD), a general practice electronic medical records database. METHODS: Patients with a record of COPD diagnosis after January 1 2008 were identified in the CPRD. Breathlessness was assessed using the Medical Research Council (MRC) dyspnoea scale, with scoring ranging from 1-5, which has been routinely administered as a part of the regular assessment of patients with COPD in the general practice since April 2009. Stepwise multivariate logistic regression estimated independent associations with dyspnoea. Negative binomial regression evaluated a relationship between breathlessness and exacerbation rate during follow-up. RESULTS: The total cohort comprised 49,438 patients diagnosed with COPD; 40,425 (82%) had any MRC dyspnoea grade recorded. Of those, 22,770 (46%) had moderate-to-severe dyspnoea (MRC >/= 3). Breathlessness increased with increasing airflow limitation; however, moderate-to-severe dyspnoea was also observed in 32% of patients with mild airflow obstruction. Other factors associated with increased dyspnoea grade included female gender, older age (>/= 70 years), obesity (BMI >/= 30), history of moderate-to-severe COPD exacerbations, and frequent visits to the general practitioner. Patients with worse breathlessness were at higher risk of COPD exacerbations during follow-up. CONCLUSIONS: Moderate-to-severe dyspnoea was reported by >40% of patients diagnosed with COPD in primary care. Presence of dyspnoea, including even a perception of mild dyspnoea (MRC = 2), was associated with increased disease severity and a higher risk of COPD exacerbations during follow-up. |
ジャーナル名 | PloS one |
投稿日 | 2014/1/16 |
投稿者 | Mullerova, Hana; Lu, Chao; Li, Hao; Tabberer, Maggie |
組織名 | Respiratory Epidemiology, GlaxoSmithKline R&D, Uxbridge, United Kingdom.;Observational Data Analytics, GlaxoSmithKline R&D, Research Triangle Park, North;Carolina, United States of America.;Global Health Outcomes, GlaxoSmithKline R&D, Uxbridge, United Kingdom. |
Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/24427316/ |