Exacerbation of chronic obstructive pulmonary diseases as a risk factor of the skeletal muscle dysfunction

Poberezhets, Vitalii; Mostovoy, Yu. M.; Demchuk, Hanna

doi:10.4103/lungindia.lungindia_185_18

Cited by 6 publications

(3 citation statements)

References 32 publications

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“…For example, impaired lung function limits exercise capacity in patients with COPD, and prolonged reductions in activity can lead to wasting atrophy of skeletal muscles and exercise intolerance, further exacerbating the dyspnea that manifests as a result of progressively limited activity. 22 , 23 Thus, the prevalence of frailty in patients with COPD is unsurprising. A review of 27 studies found that an estimated 19% were frail, with 56% meeting the criteria for pre-frailty, 3 which is consistent with our results.…”

Section: Discussionmentioning

confidence: 99%

Multidimensional Frailty Instruments Can Predict Acute Exacerbations Within One Year in Patients with Stable Chronic Obstructive Pulmonary Disease: A Retrospective Longitudinal Study

Wei,

Li,

Liu

et al. 2024

COPD

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Background Chronic obstructive pulmonary disease (COPD) is closely associated with frailty, and prevention of acute exacerbations is important for disease management. Moreover, COPD patients with frailty experience a higher risk of acute exacerbations. However, the frailty instruments that can better predict acute exacerbations remain unclear. Purpose (1) To explore the factors influencing frailty and acute exacerbations in stable COPD patients, and (2) quantify the ability of multidimensional frailty instruments to predict acute exacerbations within 1 year. Patients and methods In this retrospective longitudinal study, stable COPD patients were recruited from the outpatient department of Sichuan Provincial People’s Hospital from July 2022 to June 2023. COPD patients reviewed their frailty one year ago and their acute exacerbations within one year using face-to-face interviews with a self-developed frailty questionnaire. Frailty status was assessed using the Frailty Index (FI), frailty questionnaire (FRAIL), and Clinical Frailty Scale (CFS). One-way logistic regression was used to explore the factors influencing frailty and acute exacerbations. Multivariate logistic regression was used to establish a prediction model for acute exacerbations, and the accuracy of the three frailty instruments was compared by measuring the area under the receiver operating characteristic curve (AUC). Results A total of 120 individuals were included. Frailty incidence estimates using FI, FRAIL, and CFS were 23.3%, 11.7%, and 15.8%, respectively. The three frailty instruments showed consistency in COPD assessments ( P <0.05). After adjusting for covariates, frailty reflected by the FI and CFS score remained an independent risk factor for acute exacerbations. The CFS score was the best predictor of acute exacerbations (AUC, 0.764 (0.663–0.866); sensitivity, 57.9%; specificity, 80.0%). Moreover, the combination of CFS plus FRAIL scores was a better predictor of acute exacerbations (AUC, 0.792 (0.693–0.891); sensitivity, 86.3%; specificity, 60.0%). Conclusion Multidimensional frailty assessments could improve the identification of COPD patients at high risk of acute exacerbations and facilitate targeted interventions to reduce acute exacerbations in these patients.

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Section: Discussionmentioning

confidence: 99%

Multidimensional Frailty Instruments Can Predict Acute Exacerbations Within One Year in Patients with Stable Chronic Obstructive Pulmonary Disease: A Retrospective Longitudinal Study

Wei,

Li,

Liu

et al. 2024

COPD

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“…It has also been found that CAT scores and mMRC scores were significantly higher in patients with low PhA compared with patients with normal PhA in COPD, whereas there was no significant difference in CAT and mMRC scores between patients with low FFMI and those with normal FFMI, suggesting that PhA is more sensitive than FFMI in predicting symptoms in patients with COPD ( 44 ). A study by Vitalii et al ( 45 ) showed that the frequency of acute exacerbations of COPD was negatively correlated with FFMI. In contrast, PhA in patients with COPD is mainly affected by FFM, suggesting that PhA is a predictor of acute exacerbation in patients with COPD.…”

Section: Discussionmentioning

confidence: 99%

Correlation between body composition and disease severity in patients with chronic obstructive pulmonary disease

Jin,

Yang,

Chen

et al. 2024

Front. Med.

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BackgroundBody composition changes are important extrapulmonary manifestations in chronic obstructive pulmonary disease (COPD) patients. This study aimed to investigate the characteristics of body composition in patients with COPD, and its correlation with disease severity.MethodsA total of 105 COPD patients admitted to Zhongshan Hospital affiliated to Dalian University, from May 1, 2021 to January 31, 2023, were included as the COPD group, and 105 subjects without COPD were enrolled as the control group during the same period. According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) comprehensive assessment indicators, COPD patients were divided into groups: the degree of pulmonary function airflow limitation was grouped according to FEV1%pred; clinical symptoms were grouped according to mMRC scores and CAT scores; the risk of acute exacerbation was divided into low risk and high risk groups. Body composition was measured by bioelectrical impedance analysis (BIA).Results(1) Concerning body composition, the body mass index (BMI), fat-free mass index (FFMI), and angle of phase (PhA) of COPD patients were lower than those of the control group. Extracellular water-to-total body water ratio (ECW/TBW) and extra-to-intracellular water ratio (ECW/ICW) were higher than those of the control group, and the difference was statistically significant (p < 0.05). (2) There were differences in body composition among COPD patients with different severity of disease: FFMI and PhA in the mild/moderate airflow limitation group were higher than those in the severe/very severe airflow limitation group. According to mMRC scores classification, the FFMI and PhA of the less symptomatic group were higher than those of the more symptomatic group, and ECW/TBW and ECW/ICW were lower than those of the more symptomatic group. According to CAT scores classification, FFMI and PhA in the mild/moderate disease group were higher than those in the severe/very severe disease group. The FFMI of the low-risk group was higher than that of the high-risk group, and ECW/TBW was lower than that of the high risk group. (3) Correlation analysis between body composition and disease severity indicators showed that FFMI and PhA were negatively correlated with mMRC scores and CAT scores, and positively correlated with FEV1%pred. ECW/TBW ratio and ECW/ICW ratio were positively correlated with mMRC scores and CAT scores, and negatively correlated with FEV1%pred, and the difference was statistically significant (p < 0.05).ConclusionThere are significant differences in body composition between COPD patients and the control group, and there are significant differences in body composition between COPD patients with different severity of disease, with correlations between body composition and severity of disease.

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“…After discharge, some patients present a natural and complete functional recovery, while others may not fully recover [ 4 ]. In this sense, these physical and functional impairments may further lead to activity limitations and participation restriction, perpetuating a vicious cycle that impacts patients’ functioning levels [ 12 ]. An individualised and multidimensional assessment, identifying issues guiding a personalised care programme, enables the identification of so-called treatable traits [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Development of a performance-based toolkit of the treatable traits of functioning in hospitalised patients with exacerbation of COPD: a survey-based study protocol

Leonardi,

Kawakami,

Cruz

et al. 2024

ERJ Open Res

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BackgroundThe management of COPD has been based on the premise of identifying problems that guide personalised treatment based on a multidimensional assessment, known as treatable traits. Exacerbation of COPD (ECOPD) results in physical and functional impairments, limitation of daily activities and negative impact on patients’ quality of life and prognosis. In this context, identifying treatable traits in patients with ECOPD is essential to properly guide individualised patient care. There is a need to develop a performance-based toolkit to identify the main treatable traits of functioning in hospitalised patients with ECOPD.Methods and analysisThis is a study protocol of a survey method observational study to develop a performance-based toolkit. The study will include the following steps: 1) definition of treatable traits by both physiotherapists who provide or have provided care to hospitalised patients with ECOPD on a regular basis, and patients who have experienced at least one ECOPD which required hospitalisation; 2) selection of the most appropriate measures (markers) for each treatable trait based on established criteria and a previous systematic review; and 3) implementation of the toolkit in a pilot/feasibility study with hospitalised patients with ECOPD.ConclusionThe development of a feasible performance-based toolkit with the best markers for each key treatable trait of functioning in hospitalised patients with ECOPD will make it possible to create individualised patient care for the specific demands of these patients.

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Exacerbation of chronic obstructive pulmonary diseases as a risk factor of the skeletal muscle dysfunction

Cited by 6 publications

References 32 publications

Multidimensional Frailty Instruments Can Predict Acute Exacerbations Within One Year in Patients with Stable Chronic Obstructive Pulmonary Disease: A Retrospective Longitudinal Study

Multidimensional Frailty Instruments Can Predict Acute Exacerbations Within One Year in Patients with Stable Chronic Obstructive Pulmonary Disease: A Retrospective Longitudinal Study

Correlation between body composition and disease severity in patients with chronic obstructive pulmonary disease

Development of a performance-based toolkit of the treatable traits of functioning in hospitalised patients with exacerbation of COPD: a survey-based study protocol

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