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首页> 外文期刊>BMJ Open Respiratory Research >Longitudinal change in quality of life following hospitalisation for acute exacerbations of COPD
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Longitudinal change in quality of life following hospitalisation for acute exacerbations of COPD

机译：因COPD急性加重住院后生活质量的纵向变化

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Background Current guidelines for management of patients hospitalised with acute exacerbations of chronic obstructive pulmonary disease (COPD) recommend that clinical decisions, including escalation to assisted ventilation, be informed by an estimate of the patients’ likely postdischarge quality of life. There is little evidence to inform predictions of outcome in terms of quality of life, psychological well-being and functional status. Undue nihilism might lead to denial of potentially life-saving therapy, while undue optimism might prolong suffering when alternative palliation would be more appropriate. This study aimed to detail longitudinal changes in quality of life following hospitalisation for acute exacerbations of COPD. Methods We prospectively recruited two cohorts (exacerbations requiring assisted ventilation during admission and exacerbations not ventilated). Admission clinical data, and mortality and readmission details were collected. Quality of life, psychological well-being and functional status were formally assessed over the subsequent 12?months. Time-adjusted mean change in quality of life was examined. Results 183 patients (82 ventilated; 101 not ventilated) were recruited. On average, overall quality of life improved by a clinically important amount in those not ventilated and did not decline in ventilated patients. Both groups showed clinically important improvements in respiratory symptoms and an individual's sense of control over their condition, despite the tendency for functional status to decline. Conclusions On average, postdischarge quality of life improved in non-ventilated and did not decline in ventilated patients. Certain quality of life domains (ie, symptoms and mastery) improved significantly. Better understanding of longitudinal change in postdischarge quality of life should help to inform decision-making.
机译：背景技术当前对住院治疗的慢性阻塞性肺疾病急性加重（COPD）患者的治疗指南建议，应根据患者可能出院后的生活质量评估来做出临床决策，包括逐步升级为辅助通气。几乎没有证据可以根据生活质量，心理健康和功能状态来预测结果。过度虚无主义可能导致否认可能挽救生命的疗法，而过分乐观可能会在更合适的情况下减轻痛苦，从而延长痛苦。这项研究的目的是详细描述因COPD急性加重住院后生活质量的纵向变化。方法我们前瞻性地招募了两个队列（入院期间需要辅助通气的加重和未通气的加重）。收集入院临床数据以及死亡率和再入院详细信息。在随后的12个月内，对生活质量，心理健康状况和功能状态进行了正式评估。研究了时间调整后生活质量的平均变化。结果招募了183例患者（82例通气; 101例不通气）。平均而言，在没有通气且没有通气的患者中，总体生活质量提高了临床上重要的水平。尽管功能状态有下降的趋势，但两组患者在呼吸道症状和个人对其状况的控制感方面均显示出临床上的重要改善。结论平均而言，非通气患者的出院后生活质量得到改善，而通气患者并未降低。某些生活领域的质量（即症状和精通能力）得到了显着改善。更好地了解出院后生活质量的纵向变化应有助于为决策提供依据。

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