Fatigue linked to COPD severity, hospitalization risk

Mar 8 2013

By Mark Cowen, Senior medwireNews reporter

Fatigue is associated with disease severity in patients with chronic obstructive pulmonary disease (COPD), researchers confirm.

Importantly, Johanna Paddison (Repatriation General Hospital, Adelaide, Australia) and team also found that, independent of disease severity, fatigue is a significant predictor for hospitalization risk in patients with the lung disease.

The findings come from a study of 100 patients with stable COPD who were due to start a pulmonary rehabilitation program.

The participants were assessed at study entry for "fatigue experiences" and "fatigue impacts" using the Identity-Consequences Fatigue Scale (ICFS), and for COPD severity using the BODE (body mass index, degree of airflow obstruction, dyspnea, and exercise capacity) index.

Over the 2-month follow-up period, 24% of the COPD patients were admitted to hospital at least once, of whom more than half (58%) were admitted at least twice.

Overall, there was a significant relationship between ICFS fatigue experiences and impact scores and BODE scores in the COPD patients.

Dividing the COPD patients into three groups based on fatigue experience scores, the team found that the risk for hospitalization during follow-up was 11.4-fold greater among participants in the most severely fatigued group and 5.0-fold greater among those in the middle group compared with patients in the least fatigued group.

Similarly, COPD patients in the highest third for fatigue impact scores were 13.6 times more likely to be hospitalized than those in lowest third for fatigue impact scores. However, there was no significant difference in risk for hospitalization between COPD patients in the middle group for fatigue impact scores and those in highest and lowest scoring groups.

Paddison et al conclude in the European Respiratory Journal: "This study confirms that fatigue reports are systematically related to markers of COPD disease severity.

"Of greater clinical importance, our results show that, independent of disease severity, fatigue is a strong predictor of hospitalisation risk, which is itself an important driver of impaired quality of life, negative impact on self and family, escalation of personal and societal costs, and ongoing instability and mortality."

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