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Validation of clinical control in COPD as a new tool for optimizing treatment
- Source :
- International Journal of Chronic Obstructive Pulmonary Disease
- Publication Year :
- 2018
- Publisher :
- Dove Press, 2018.
-
Abstract
- Juan José Soler-Cataluña,1,2 Maribel Marzo,3 Pablo Catalán,1 Cristina Miralles,1 Bernardino Alcazar,2,4 Marc Miravitlles2,5 1Pneumology Department, Hospital Arnau de Vilanova, Valencia, Spain; 2CIBER of Respiratory Diseases (CIBERES), Spain; 3Emergency Department, Hospital General de Requena, Valencia, Spain; 4Respiratory Department, Hospital de Alta Resolución de Loja, Granada, Spain; 5Pneumology Department, University Hospital Vall d’Hebron/Vall d’Hebron Research Institute (VHIR), Barcelona, Spain Background: It has recently been proposed that the concept of clinical control in COPD may be useful for deciding treatment in COPD, but the original control criteria (OCC) were considered too restrictive.Objective: Define and subsequently validate “modified” control criteria (MCC) of COPD.Method: Prospective observational study in COPD patients with a 1-year follow-up. Control was defined as the presence of low clinical impact and clinical stability. To evaluate clinical impact, the following clinical parameters were assessed: the degree of dyspnea, use of rescue medication, physical activity, and sputum color. Stability was assessed by clinical changes and exacerbations in the last 3 months. The COPD assessment test score and their changes were also evaluated as alternative control criteria. To define the MCC, adjustment for disease severity using BODEx index (MCC-B) or FEV1 (MCC-F) was evaluated, and the best cutoff point was established. Time to first combined event (emergency visit, hospitalization, or death) was analyzed to evaluate the predictive capacity of risk of the OCC, MCC-B, and MCC-F.Results: We included 265 patients, 224 (83.9%) men, with a mean age (±SD) of 68±9 years and FEV1 of 58%±17%. The proportion of controlled patients was higher using clinical MCC-B or MCC-F (61.5% and 59.6%) than OCC (27.5%). Similar percentages were found using COPD assessment test scores. The time to the first combined event was significantly greater in controlled patients using MCC criteria (P
- Subjects :
- Male
Time Factors
Health Status
outcomes
Severity of Illness Index
Pulmonary Disease, Chronic Obstructive
0302 clinical medicine
Quality of life
Risk Factors
Forced Expiratory Volume
Health Status Indicators
Prospective Studies
030212 general & internal medicine
Lung
Original Research
Aged, 80 and over
COPD
Exercise Tolerance
food and beverages
CAT
General Medicine
Middle Aged
Bronchodilator Agents
Hospitalization
Treatment Outcome
Disease Progression
Female
medicine.medical_specialty
Clinical Decision-Making
International Journal of Chronic Obstructive Pulmonary Disease
Lower risk
Risk Assessment
Decision Support Techniques
03 medical and health sciences
Predictive Value of Tests
Internal medicine
medicine
Humans
Alternative control
Exercise
Aged
business.industry
Sputum
Reproducibility of Results
medicine.disease
Rescue medication
Dyspnea
030228 respiratory system
Copd assessment test
Observational study
Cutoff point
business
control
Subjects
Details
- Language :
- English
- ISSN :
- 11782005
- Database :
- OpenAIRE
- Journal :
- International Journal of Chronic Obstructive Pulmonary Disease
- Accession number :
- edsair.doi.dedup.....d53cf91368a9666c74a6b8cd06f0cf7b