Reports of low energy levels or feelings of fatigue could be used to predict risk of hospitalisation for people with chronic obstructive pulmonary disease (COPD), according to a new study published online ahead of print in the European Respiratory Journal.
The findings of the study could be used by doctors to help reduce the number of admissions to hospital for people with COPD, which could lead to improvements in quality of life and a reduction in the economic impact of the disease.
Fatigue has been reported as the second most prevalent symptom of COPD, after breathlessness. Symptoms of fatigue can be both physical and mental and include a lack of energy or a loss of concentration.
To investigate the link between fatigue and COPD, the researchers assessed 83 people attending a pulmonary rehabilitation clinic to manage their condition. Participants completed a questionnaire about their feelings of fatigue. Using the results from the questionnaire, unit scores from 0-10 were generated showing participants' experience of fatigue with a higher score equating to greater fatigue.
The researchers also measured breathlessness and levels of airway obstruction, along with hospital records for a period of 20 months.
The results showed people reporting the most severe levels of fatigue were the most likely to be hospitalised. Compared to the lowest third of patients, the third of patients reporting the most intense scores on fatigue impacts showed a 13.6-fold increase in risk of hospitalisation within 20 months.
The length of hospital stays also increased by a factor of almost 4 for each unit increase in patients' reports of fatigue experiences.
The findings suggest that reported levels of fatigue are associated with the severity of COPD. The study also shows that fatigue is also a strong predictor of hospitalisation for people with COPD.
Lead author of the study, Dr Johanna Paddison, from the Repatriation General Hospital in Adelaide, Australia, said: "There has been little research into the clinical significance of reports of fatigue. Our study has helped to show that patient's experiences of fatigue could be used as a predictor of hospital admissions. As hospitalisations for COPD can impact upon quality of life and have economic consequences, the results of this study have significant implications for the management of COPD."
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Fatigue in COPD: association with functional status and hospitalisations, J.S. Paddison, T.W. Effing, S. Quinn and P.A. Frith, DOI: 10.1183/09031936.00021412