Global muscle dysfunction as a risk factor of readmission to hospital due to COPD exacerbations

Vilaró, Jordi; Ramírez-Sarmiento, Alba; Martínez‐Llorens, Juana; Mendoza, Teresa; Álvarez, M.A. Lobo; Sánchez-Cayado, Natalia; Vega, Angeles; Gimeno, Elena; Coronell, Carlos; Gea, Joaquim; Roca, Josep; Orozco-Levi, Mauricio

doi:10.1016/j.rmed.2010.05.001

Cited by 106 publications

(100 citation statements)

References 20 publications

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“…In fact, patients with history of multiple hospital admissions for COPD exacerbation have greater expiratory muscle strength than more stable patients. 7,8 Regarding quadriceps peak torque, we observed no difference between the 3 assessment days, similar to Troosters et al 18 Two other studies, 5,6 however, found a decrease of 5% of predicted in quadriceps peak torque during the hospitalization period. Besides the study of Troosters et al, 18 which found no decrease in this variable, Spruit et al 6 found that 48% of their subjects had no change or an increase in quadriceps peak torque.…”

Section: Discussionsupporting

confidence: 88%

“…On day 1 the proportion of subjects with reduced inspiratory capacity (Ͻ 80% of predicted 25 ) was the same as the percentage with inspiratory muscle dysfunction (suggested by Vilaró et al 7 , as P Imax Ͻ 70% of predicted), which is 13 subjects (68%). Indeed, the inspiratory capacity of patients with inspiratory muscle dysfunction was lower than that of patients without inspiratory muscle dysfunction (62% of predicted [53-72% of predicted] vs 93% of predicted [71-139% of predicted], respectively, P ϭ .02), and the classifications of reduced inspiratory capacity and inspiratory muscle dysfunction were associated (phi coefficient 0.62, P ϭ .03).…”

Section: Respiratory Muscle Strength During and After Hospitalizationsupporting

confidence: 69%

“…Two recent cross-sectional studies found that respiratory muscle dysfunction is associated with an increased risk of hospital admission for exacerbation. 7,8 Two other prospective studies identified inspiratory muscle overload as a risk factor for hospitalization for exacerbation. 9,10 Surprisingly, the respiratory muscle function during and after COPD exacerbation seems to have been poorly investigated.…”

Section: Introductionmentioning

confidence: 99%

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Respiratory Muscle Strength During and After Hospitalization for COPD Exacerbation

et al. 2013

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BACKGROUND: A more profound investigation of respiratory muscle strength during COPD exacerbation was needed, so we investigated respiratory muscle strength and related factors in patients with COPD during and after hospitalization for COPD exacerbation. METHODS: In 19 subjects hospitalized for COPD exacerbation (12 males, mean age 67 ؎ 11 y, median percent-ofpredicted FEV 1 26% [IQR 19 -32%]) we measured lung function and respiratory and quadriceps muscle strength at admission (day 1), at discharge, and 1 month after discharge. RESULTS: At admission, 68% of the subjects had inspiratory muscle dysfunction (maximum inspiratory pressure < 70% of predicted O], P ‫؍‬ .001). Inspiratory capacity increased between discharge (1.59 ؎ 0.44 L) and 1 month after discharge (1.99 ؎ 0.54 L, P ‫؍‬ .02). There was no significant change in other lung function variables or quadriceps strength. At admission the inspiratory muscle dysfunction and reduction in inspiratory capacity (< 80% of predicted) correlated linearly (phi coefficient 0.62, P ‫؍‬ .03), whereas the expiratory muscle strength correlated inversely with FEV 1 (Spearman rho ؊0.61, P ‫؍‬ .005) and inspiratory capacity (Spearman rho ؊0.54, P ‫؍‬ .02). CONCLUSIONS: There was a high prevalence of inspiratory muscle dysfunction in patients hospitalized for COPD exacerbation. Inspiratory and expiratory muscle strength increased markedly during and after hospitalization. The degree of air-flow obstruction and hyperinflation were related to inspiratory and expiratory muscle strength.

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Section: Discussionsupporting

confidence: 88%

Section: Respiratory Muscle Strength During and After Hospitalizationsupporting

confidence: 69%

Section: Introductionmentioning

confidence: 99%

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Respiratory Muscle Strength During and After Hospitalization for COPD Exacerbation

et al. 2013

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“…Vücut kompozisyonu KOAH tanılı olgularda yaşam süresi ve prognozu etkilediğinden gerekli ölçüm yapılması ve gerekli olgularda destek tedavisi başlan-ması, takipleri oldukça önemlidir (1,2). Nütrisyonel değerlendirme ve destek tedavisi multidispliner kapsamlı pulmoner rehabilitasyon (PR) programlarının en önemli bileşenlerinden biridir.…”

Section: Introductionunclassified

Oral nutritional supplement in patients with COPD who completed PR program: six months and one year follow ups

et al. 2018

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An initial cohort of 36 stable COPD subjects (GOLD 2-4) from the AERIS (3) study was analysed.

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confidence: 99%

Do lean markers relate to exacerbation rate in chronic obstructive pulmonary disease? Preliminary results from AERIS study

et al. 2015

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Previous studies suggested body composition may be related to COPD progression (1) however no definitive studies link lean markers (muscle mass or function) to exacerbation frequency (2) . We aimed to investigate this relationship.An initial cohort of 36 stable COPD subjects (GOLD 2-4) from the AERIS (3) study was analysed. Fat free mass (FFM) was assessed by bioelectrical impedance and function with grip strength (GS), grip endurance (GE) and six minute walk test (6MWT). FFM, impedance at 50kHz (Imp50) and GS were adjusted for height and presented as indexes (i). Frequency of exacerbations was prospectively recorded for 12 months and adjusted for length of follow up. A rate of >0·17 exacerbation/month (i.e. ⩾2 exacerbations/year) indicated frequent exacerbators. Schols lean depletion cutoffs (FFMi <16 male, <15 female kg/m 2 ) were applied. 75% (27) subjects were defined as frequent exacerbators: 53% moderate, 88% severe and 100% very severe COPD subjects. COPD severity and exacerbation rates were similar between genders (0·3 exacerbations/month).Women had significantly lower weight, FFM, FFMi, GS and GSi but higher Imp50 and Imp50i than men (all p < 0·05). In women alone, FEV 1 % was significantly related to FFMi (r = 0·52) and to 6MWT (r = 0·61). FFMi, GS, GSi and GE were significantly related to 6MWT (r = 0·49; 0·81; 0·72; 0·49 respectively).There were no statistical significant differences for FFM, FFMi, GE, GS, GSi, Imp50, Imp50i, or 6MWT between the frequent and nonfrequent exacerbator groups for either men or women. For men, there could be a trend towards frequent exacerbators for low 6MWT and high IMP50 values. Using Schols criteria 36% of subjects (2 male, 11 female) were lean deplete, and the exacerbation rates were similar in the 2 subgroups.Our preliminary results do not provide evidence that FFMi, Imp50, GS or 6MWT are associated with a higher frequency of exacerbation, however Imp50 and 6MWT in men may have predictive value. Lack of statistical significance may be due to the small sample size and high proportion of frequent exacerbators. Further analysis of the full AERIS cohort may yield more information on the predictive value of lean markers on exacerbation frequency and treatment response.

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Global muscle dysfunction as a risk factor of readmission to hospital due to COPD exacerbations

Abstract: Muscle dysfunction, adjusted by GOLD stage, is associated with an increased risk of hospital admissions due to acute episodes of exacerbation of the disease. Current exacerbations further deteriorate muscle dysfunction.

Cited by 106 publications

References 20 publications

Respiratory Muscle Strength During and After Hospitalization for COPD Exacerbation

Respiratory Muscle Strength During and After Hospitalization for COPD Exacerbation

Oral nutritional supplement in patients with COPD who completed PR program: six months and one year follow ups

Do lean markers relate to exacerbation rate in chronic obstructive pulmonary disease? Preliminary results from AERIS study

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