Tags

Type your tag names separated by a space and hit enter

Depressive symptoms and chronic obstructive pulmonary disease: effect on mortality, hospital readmission, symptom burden, functional status, and quality of life.
Arch Intern Med 2007; 167(1):60-7AI

Abstract

BACKGROUND

Depressive symptoms are common among patients with chronic obstructive pulmonary disease (COPD), but depression's impact on COPD outcomes has not been fully investigated. We evaluated the impact of comorbid depression on mortality, hospital readmission, smoking behavior, respiratory symptom burden, and physical and social functioning in patients with COPD.

METHODS

In this prospective cohort study, 376 consecutive patients with COPD hospitalized for acute exacerbation were followed up for 1 year. The independent associations of baseline comorbid depression (designated as a Hospital Anxiety and Depression Scale score of > or =8) with mortality, hospital readmission, length of stay, persistent smoking, and quality of life (determined by responses to the St George Respiratory Questionnaire) were evaluated after adjusting for potential confounders.

RESULTS

The prevalence of depression at admission was 44.4%. The median follow-up duration was 369 days, during which 57 patients (15.2%) died, and 202 (53.7%) were readmitted at least once. Multivariate analyses showed that depression was significantly associated with mortality (hazard ratio, 1.93; 95% confidence interval, 1.04-3.58), longer index stay (mean, 1.1 more days; P = .02) and total stay (mean, 3.0 more days; P = .047), persistent smoking at 6 months (odds ratio, 2.30; 95% confidence interval, 1.17-4.52), and 12% to 37% worse symptoms, activities, and impact subscale scores and total score on the St George Respiratory Questionnaire at the index hospitalization and 1 year later, even after controlling for chronicity and severity of COPD, comorbidities, and behavioral, psychosocial, and socioeconomic variables.

CONCLUSIONS

Comorbid depressive symptoms in patients with COPD are associated with poorer survival, longer hospitalization stay, persistent smoking, increased symptom burden, and poorer physical and social functioning. Interventions that reduce depressive symptoms may potentially affect COPD outcomes.

Authors+Show Affiliations

Gerontological Research Programme, Faculty of Medicine, National University of Singapore, Singapore. pcmngtp@nus.edu.sgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17210879

Citation

Ng, Tze-Pin, et al. "Depressive Symptoms and Chronic Obstructive Pulmonary Disease: Effect On Mortality, Hospital Readmission, Symptom Burden, Functional Status, and Quality of Life." Archives of Internal Medicine, vol. 167, no. 1, 2007, pp. 60-7.
Ng TP, Niti M, Tan WC, et al. Depressive symptoms and chronic obstructive pulmonary disease: effect on mortality, hospital readmission, symptom burden, functional status, and quality of life. Arch Intern Med. 2007;167(1):60-7.
Ng, T. P., Niti, M., Tan, W. C., Cao, Z., Ong, K. C., & Eng, P. (2007). Depressive symptoms and chronic obstructive pulmonary disease: effect on mortality, hospital readmission, symptom burden, functional status, and quality of life. Archives of Internal Medicine, 167(1), pp. 60-7.
Ng TP, et al. Depressive Symptoms and Chronic Obstructive Pulmonary Disease: Effect On Mortality, Hospital Readmission, Symptom Burden, Functional Status, and Quality of Life. Arch Intern Med. 2007 Jan 8;167(1):60-7. PubMed PMID: 17210879.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Depressive symptoms and chronic obstructive pulmonary disease: effect on mortality, hospital readmission, symptom burden, functional status, and quality of life. AU - Ng,Tze-Pin, AU - Niti,Mathew, AU - Tan,Wan-Cheng, AU - Cao,Zhenying, AU - Ong,Kian-Chung, AU - Eng,Philip, PY - 2007/1/11/pubmed PY - 2007/1/26/medline PY - 2007/1/11/entrez SP - 60 EP - 7 JF - Archives of internal medicine JO - Arch. Intern. Med. VL - 167 IS - 1 N2 - BACKGROUND: Depressive symptoms are common among patients with chronic obstructive pulmonary disease (COPD), but depression's impact on COPD outcomes has not been fully investigated. We evaluated the impact of comorbid depression on mortality, hospital readmission, smoking behavior, respiratory symptom burden, and physical and social functioning in patients with COPD. METHODS: In this prospective cohort study, 376 consecutive patients with COPD hospitalized for acute exacerbation were followed up for 1 year. The independent associations of baseline comorbid depression (designated as a Hospital Anxiety and Depression Scale score of > or =8) with mortality, hospital readmission, length of stay, persistent smoking, and quality of life (determined by responses to the St George Respiratory Questionnaire) were evaluated after adjusting for potential confounders. RESULTS: The prevalence of depression at admission was 44.4%. The median follow-up duration was 369 days, during which 57 patients (15.2%) died, and 202 (53.7%) were readmitted at least once. Multivariate analyses showed that depression was significantly associated with mortality (hazard ratio, 1.93; 95% confidence interval, 1.04-3.58), longer index stay (mean, 1.1 more days; P = .02) and total stay (mean, 3.0 more days; P = .047), persistent smoking at 6 months (odds ratio, 2.30; 95% confidence interval, 1.17-4.52), and 12% to 37% worse symptoms, activities, and impact subscale scores and total score on the St George Respiratory Questionnaire at the index hospitalization and 1 year later, even after controlling for chronicity and severity of COPD, comorbidities, and behavioral, psychosocial, and socioeconomic variables. CONCLUSIONS: Comorbid depressive symptoms in patients with COPD are associated with poorer survival, longer hospitalization stay, persistent smoking, increased symptom burden, and poorer physical and social functioning. Interventions that reduce depressive symptoms may potentially affect COPD outcomes. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/17210879/Depressive_symptoms_and_chronic_obstructive_pulmonary_disease:_effect_on_mortality_hospital_readmission_symptom_burden_functional_status_and_quality_of_life_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/archinte.167.1.60 DB - PRIME DP - Unbound Medicine ER -