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Review
. 2020 Jun:78:28-35.
doi: 10.1016/j.ijsu.2020.04.010. Epub 2020 Apr 15.

Moderate and severe exacerbations have a significant impact on health-related quality of life, utility, and lung function in patients with chronic obstructive pulmonary disease: A meta-analysis

Jiangzhou Guo  1 , Yaping Chen  2 , Weidong Zhang  3 , Shuai Tong  4 , Jige Dong  5
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Free article
Review

Moderate and severe exacerbations have a significant impact on health-related quality of life, utility, and lung function in patients with chronic obstructive pulmonary disease: A meta-analysis

Jiangzhou Guo et al. Int J Surg. 2020 Jun.
Free article

Abstract

Background: Exacerbations of chronic obstructive pulmonary disease (COPD) may increase the risk of morbidity and mortality as well as pulmonary complications after surgery among patients with COPD. This meta-analysis was designed to explore the impact of moderate and severe exacerbations of COPD on health-related quality of life (HRQoL), utility, and lung function in patients with COPD.

Methods: The individual impacts of moderate and severe exacerbations on St George's Respiratory Questionnaire (SGRQ), COPD Assessment Test (CAT), and EuroQoL-5 dimensions 5 level (EQ-5D-5L) scores, and on forced expiratory volume in 1 s (FEV1) were assessed. Adjustments were applied to account for differences in study design. Outcomes were measured at specific time points across a 12-month study period, for all patients and for subsets with either no or ≥1 severe exacerbations in the year before study entry. The proximity of each measurement in relation to a specific exacerbation was also assessed.

Results: A total of seven randomized clinical trials (RCTs) ≥12-month interventional/observational studies with 18,746 COPD patients were assessed. Overall, 4,483 (24%) patients had ≥1 severe exacerbation in the previous year. Moderate and severe exacerbations were associated with worsening from baseline in SGRQ, CAT, EQ-5D-5L, and FEV1 measures; severe exacerbations had greater impact than moderate exacerbations.

Conclusions: Moderate and severe exacerbations have a substantial and lasting impact on HRQoL, utility, and lung function in patients with COPD, highlighting a need for effective exacerbation prevention.

Keywords: Chronic obstructive pulmonary disease; Exacerbations; Health-related quality of life.

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Conflict of interest statement

Declaration of competing interest The author declared no interests.

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