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Exacerbations and time spent outdoors in chronic obstructive pulmonary disease

Exacerbations and time spent outdoors in chronic obstructive pulmonary disease
Exacerbations and time spent outdoors in chronic obstructive pulmonary disease
Patients with chronic obstructive pulmonary disease have a progressive reduction in activity, although its time scale and the contribution of exacerbations are unknown. A rolling cohort of 147 patients (101 male; mean age, 88.5 years; and forced expiratory volume in 1 second as percent predicted, 38.4%) were monitored for a median of 1,044 days (interquartile range, 685 to 1,779) over an 8-year period starting in March 1996. Patients recorded any increase in daily respiratory symptoms and time spent outside their home. They completed the St. George's Respiratory Questionnaire yearly. They experienced 1,465 exacerbations and time outdoors decreased by -0.16 hours/day per year (p < 0.001). This decline was faster in frequent exacerbators (p = 0.011). Before exacerbation, the patients stayed indoors all day for 2.1 days/week (on any day 34.1% were at home), but for 5 weeks postexacerbation they spent 2.5 days/week at home (p < 0.001) (44.4% remaining at home at onset; p = 0.021). St. George's total, activity, and impact scores were independently associated with time outdoors (p < 0.005), but not with symptom score. In conclusion, time spent outside the home declines over time and acutely at exacerbation. Patients with frequent exacerbations are more likely to become housebound and need targeting in rehabilitation programs.
1073-449X
446-452
Donaldson, Gavin C.
48128ec1-2e2d-4ad8-9183-5eb8e70b0cd0
Wilkinson, Tom M.A.
8c55ebbb-e547-445c-95a1-c8bed02dd652
Hurst, John R.
37c4256e-b20f-4df0-ada0-cf3cbd59ecdf
Perera, Wayomi R.
e1b2cfd4-a695-46f7-8e96-e156bc4e2abb
Wedzicha, Jadwiga A.
da6d3d6a-9098-4681-9ab6-b5bad0325e52
Donaldson, Gavin C.
48128ec1-2e2d-4ad8-9183-5eb8e70b0cd0
Wilkinson, Tom M.A.
8c55ebbb-e547-445c-95a1-c8bed02dd652
Hurst, John R.
37c4256e-b20f-4df0-ada0-cf3cbd59ecdf
Perera, Wayomi R.
e1b2cfd4-a695-46f7-8e96-e156bc4e2abb
Wedzicha, Jadwiga A.
da6d3d6a-9098-4681-9ab6-b5bad0325e52

Donaldson, Gavin C., Wilkinson, Tom M.A., Hurst, John R., Perera, Wayomi R. and Wedzicha, Jadwiga A. (2005) Exacerbations and time spent outdoors in chronic obstructive pulmonary disease. American Journal of Respiratory and Critical Care Medicine, 171 (5), 446-452. (doi:10.1164/rccm.200408-1054OC).

Record type: Article

Abstract

Patients with chronic obstructive pulmonary disease have a progressive reduction in activity, although its time scale and the contribution of exacerbations are unknown. A rolling cohort of 147 patients (101 male; mean age, 88.5 years; and forced expiratory volume in 1 second as percent predicted, 38.4%) were monitored for a median of 1,044 days (interquartile range, 685 to 1,779) over an 8-year period starting in March 1996. Patients recorded any increase in daily respiratory symptoms and time spent outside their home. They completed the St. George's Respiratory Questionnaire yearly. They experienced 1,465 exacerbations and time outdoors decreased by -0.16 hours/day per year (p < 0.001). This decline was faster in frequent exacerbators (p = 0.011). Before exacerbation, the patients stayed indoors all day for 2.1 days/week (on any day 34.1% were at home), but for 5 weeks postexacerbation they spent 2.5 days/week at home (p < 0.001) (44.4% remaining at home at onset; p = 0.021). St. George's total, activity, and impact scores were independently associated with time outdoors (p < 0.005), but not with symptom score. In conclusion, time spent outside the home declines over time and acutely at exacerbation. Patients with frequent exacerbations are more likely to become housebound and need targeting in rehabilitation programs.

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Published date: March 2005

Identifiers

Local EPrints ID: 47982
URI: https://eprints.soton.ac.uk/id/eprint/47982
ISSN: 1073-449X
PURE UUID: b01fb0e9-642d-4b63-92d4-06d07fab40a3

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Date deposited: 16 Aug 2007
Last modified: 13 Mar 2019 20:58

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Contributors

Author: Gavin C. Donaldson
Author: John R. Hurst
Author: Wayomi R. Perera
Author: Jadwiga A. Wedzicha

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