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Cited by 240Chronic Obstructive Pulmonary Disease (COPD) ResearchHealth Systems, Economic Evaluations, Quality of LifeAsthma and respiratory diseases

Using quality of life to predict hospitalization and mortality in patients with obstructive lung diseases

Fan, Vincent S., Curtis, J. Randall, Tu, Shin-Ping, McDonell, Mary B., Fihn, Stephan D.·2002·Chest
DOI 10.1378/chest.122.2.429
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Abstract

Study objectives Condition-specific measures of quality of life (QOL) for patients with COPD have been demonstrated to be highly reliable and valid, but they have not conclusively been shown to predict hospitalization or death.Objective We sought to determine whether a brief, self-administered, COPD-specific QOL measure, the Seattle Obstructive Lung Disease Questionnaire (SOLDQ), could accurately predict hospitalizations and death.Design Prospective cohort study.Setting Patients enrolled in the primary care clinics at seven Department of Veterans Affairs (VA) medical centers participating in the Ambulatory Care Quality Improvement Project.Patients Of 24,458 patients who completed a health inventory, 5,503 reported having chronic lung disease. The 3,282 patients who completed the baseline SOLDQ were followed for 12 months.Measurements Hospitalization and all-cause mortality during the 1-year follow-up period.Results During the follow-up period, 601 patients (18.3%) were hospitalized, 141 (4.3%) for COPD exacerbations, and 167 patients (5.1%) died. After adjusting for age, VA hospital site, distance to the VA hospital, employment status, and smoking status, the relative risk of any hospitalization among patients with scores on the emotional, physical, and coping skills scales of the SOLDQ that were in the lowest quartile, when compared to the highest quartile, were 2.0 (95% confidence interval [CI], 1.5 to 2.6), 2.5 (95% CI, 1.9 to 3.4), and 1.9 (95% CI, 1.5 to 2.5), respectively. When hospitalizations were restricted to those specifically for COPD, the odds ratio (OR) for the lowest quartile of physical function was 6.0 (95% CI, 3.1 to 11.5). Similarly, patients in the lowest quartile of physical function also had an increased risk of death (OR, 6.8; 95% CI, 3.3 to 13.8). When adjusted for comorbidity (OR, 0.8; 95% CI, 0.5 to 1.2), long-term steroid use (OR, 2.8; 95% CI, 1.6 to 4.9), and prior hospitalization for COPD (OR, 4.5; 95% CI, 2.2 to 9.2), patients having baseline SOLDQ physical function scores in the lowest quartile had an odds of hospitalization for COPD that was fivefold higher than patients with scores in the highest quartile (OR, 5.0; 95% CI, 2.6 to 9.7).Conclusions Lower QOL is a powerful predictor of hospitalization and all-cause mortality. Brief, self-administered instruments such as the SOLDQ may provide an opportunity to identify patients who could benefit from preventive interventions.

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  • Mood disorders may lead to increased risk of hospitalization and rehospitalization by compromising health status.

    “By compromising health status, mood disorders may lead to increased risk of hospitalization59 and rehospitalization.60”

    From Anxiety and Depression in COPD (2008) · cites this paper as [59]

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Authors
Fan, V. S., Curtis, J. R., Tu, S.-P., McDonell, M. B., & Fihn, S. D.
Affiliations
  • VA Puget Sound Health Care System (US)
  • University of Washington (US)
Corresponding author
Fan, Vincent S.
ORCID
Venue
Chest
Publisher
Elsevier BV
Published
2002-08
Volume
122
Issue
2
Pages
429-436
ISSN
0012-3692 (ISSN-L)
DOI
10.1378/chest.122.2.429
OpenAlex
W2129782191
Cited by
240
References
26
Citations by year
2026: 1 · 2025: 2 · 2024: 4 · 2023: 13 · 2022: 5 · 2021: 5 · 2020: 12 · 2019: 2 · 2018: 5 · 2017: 7 · 2016: 8 · 2015: 17 · 2014: 13 · 2013: 8 · 2012: 7
FWCI
9.56
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • CHEST Journal (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
  • Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
Keywords
quality of life, chronic obstructive pulmonary disease, obstructive lung disease, hospitalization prediction, mortality prediction, physical function, emotional functioning, coping strategies, COPD exacerbations, veterans, primary care, comorbidities, steroid use, disease severity assessment, health care costs
MeSH terms
Aged, Female, Follow-Up Studies, Hospitalization, Humans, Male, Middle Aged, Predictive Value of Tests, Quality of Life, Surveys and Questionnaires, Risk Factors, Severity of Illness Index, Time Factors, Cohort Studies, Comorbidity, Risk Assessment, Pulmonary Disease, Chronic Obstructive

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