help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Published ahead of print on December 3, 2004, doi:10.1164/rccm.200408-1054OC

Am. J. Respir. Crit. Care Med., Volume 171, Number 5, March 2005, 446-452

A more recent version of this article appeared on March 1, 2005
This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
200408-1054OCv1
171/5/446    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Donaldson, G. C
Right arrow Articles by Wedzicha, J. A
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Donaldson, G. C
Right arrow Articles by Wedzicha, J. A

Submitted on August 15, 2004
Accepted on November 30, 2004

Exacerbations, and time spent outdoors in Chronic Obstructive Pulmonary Disease

Gavin C Donaldson1, Thomas MA Wilkinson1, John R Hurst1, Wayomi R Perera1, and Jadwiga A Wedzicha1*

1 Academic Unit of Respiratory Medicine, St. Bartholomew's and the Royal London School of Medicine and Dentistry, London, United Kingdom

* To whom correspondence should be addressed. E-mail: j.a.wedzicha{at}qmul.ac.uk.

Patients with chronic obstructive pulmonary disease have a progressive reduction in activity, though its timescale and the contribution of exacerbations are unknown. A rolling cohort of 147 patients (101 male; mean age 88.5 years and forced expiratory volume in 1 second as % predicted of 38.4%) were monitored for a median of 1044 days (Inter-quartile range 685 to 1779) over an 8 year period starting March 1996. Patients recorded increase in daily respiratory symptoms and time spent outside their home. They completed the St. Georges Respiratory Questionnaire yearly. They experienced 1465 exacerbations and time outdoors decreased by -0.16 hours/day/year (P<0.001). This decline was faster in frequent exacerbators (P=0.011). Prior to exacerbation, the patients stayed indoors all day for 2.1 days/week (on any day 34.1% were at home), but for 5 weeks post exacerbation they spent 2.5 days/week at home (P<0.001) (44.4 % remaining at home at onset; P=0.021). St Georges' total, activity and impact scores were independently associated with time outdoors (P<0.005) but not symptom score. In conclusion, time spent outside the home declines over time and acutely at exacerbation. Patients with frequent exacerbations are more likely to become housebound and need targeting in rehabilitation programmes.
Key words: Chronic obstructive pulmonary disease, housebound, FEV1 decline, quality of life, exacerbations




This article has been cited by other articles:


Home page
 Am. J. Respir. Crit. Care Med.Home page
F. Garcia-Rio, V. Lores, O. Mediano, B. Rojo, A. Hernanz, E. Lopez-Collazo, and R. Alvarez-Sala
Daily Physical Activity in Patients with Chronic Obstructive Pulmonary Disease Is Mainly Associated with Dynamic Hyperinflation
Am. J. Respir. Crit. Care Med., September 15, 2009; 180(6): 506 - 512.
[Abstract] [Full Text] [PDF]

Home page
 Ther Adv Respir DisHome page
A. Anzueto and M. Miravitlles
Efficacy of tiotropium in the prevention of exacerbations of COPD
Therapeutic Advances in Respiratory Disease, June 1, 2009; 3(3): 103 - 111.
[Abstract] [PDF]

Home page
 Eur Respir JHome page
M. Miravitlles, C. Llor, R. de Castellar, I. Izquierdo, E. Baro, and E. Donado
Validation of the COPD severity score for use in primary care: the NEREA study
Eur. Respir. J., March 1, 2009; 33(3): 519 - 527.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
M. I. Polkey and K. F. Rabe
Chicken or egg: physical activity in COPD revisited
Eur. Respir. J., February 1, 2009; 33(2): 227 - 229.
[Full Text] [PDF]

Home page
 Eur Respir JHome page
M. G. Foreman, D. L. DeMeo, C. P. Hersh, V. J. Carey, V. S. Fan, J. J. Reilly, S. D. Shapiro, and E. K. Silverman
Polymorphic variation in surfactant protein B is associated with COPD exacerbations
Eur. Respir. J., October 1, 2008; 32(4): 938 - 944.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
F. Pitta, T. Troosters, V. S. Probst, D. Langer, M. Decramer, and R. Gosselink
Are Patients With COPD More Active After Pulmonary Rehabilitation?
Chest, August 1, 2008; 134(2): 273 - 280.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
J. K. Quint, R. Baghai-Ravary, G. C. Donaldson, and J. A. Wedzicha
Relationship between depression and exacerbations in COPD
Eur. Respir. J., July 1, 2008; 32(1): 53 - 60.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
K. H. Groenewegen, D. S. Postma, W. C. J. Hop, P. L. M. L. Wielders, N. J. J. Schlosser, E. F. M. Wouters, and for the COSMIC Study Group
Increased Systemic Inflammation Is a Risk Factor for COPD Exacerbations*
Chest, February 1, 2008; 133(2): 350 - 357.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
M. G. Foreman, D. L. DeMeo, C. P. Hersh, J. J. Reilly, and E. K. Silverman
Clinical determinants of exacerbations in severe, early-onset COPD
Eur. Respir. J., December 1, 2007; 30(6): 1124 - 1130.
[Abstract] [Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
A. Anzueto, S. Sethi, and F. J. Martinez
Exacerbations of Chronic Obstructive Pulmonary Disease
Proceedings of the ATS, October 1, 2007; 4(7): 554 - 564.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
D. J. Powrie, T. M. A. Wilkinson, G. C. Donaldson, P. Jones, K. Scrine, K. Viel, S. Kesten, and J. A. Wedzicha
Effect of tiotropium on sputum and serum inflammatory markers and exacerbations in COPD
Eur. Respir. J., September 1, 2007; 30(3): 472 - 478.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
S. J. Carr, R. S. Goldstein, and D. Brooks
Acute Exacerbations of COPD in Subjects Completing Pulmonary Rehabilitation
Chest, July 1, 2007; 132(1): 127 - 134.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
H. Gunen, S. S. Hacievliyagil, O. Yetkin, G. Gulbas, L. C. Mutlu, and E. In
The role of nebulised budesonide in the treatment of exacerbations of COPD
Eur. Respir. J., April 1, 2007; 29(4): 660 - 667.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
W. R. Perera, J. R. Hurst, T. M. A. Wilkinson, R. J. Sapsford, H. Mullerova, G. C. Donaldson, and J. A. Wedzicha
Inflammatory changes, recovery and recurrence at COPD exacerbation
Eur. Respir. J., March 1, 2007; 29(3): 527 - 534.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
P. Kardos, M. Wencker, T. Glaab, and C. Vogelmeier
Impact of Salmeterol/Fluticasone Propionate versus Salmeterol on Exacerbations in Severe Chronic Obstructive Pulmonary Disease
Am. J. Respir. Crit. Care Med., January 15, 2007; 175(2): 144 - 149.
[Abstract] [Full Text] [PDF]

Home page
 ERRHome page
P. M. A. Calverley
Exercise and dyspnoea in COPD
Eur. Respir. Rev., December 1, 2006; 15(100): 72 - 79.
[Abstract] [Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
D. M. G. Halpin and M. Miravitlles
Chronic Obstructive Pulmonary Disease: The Disease and Its Burden to Society
Proceedings of the ATS, September 1, 2006; 3(7): 619 - 623.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
L. M. Fabbri, F. Luppi, B. Beghe, and K. F. Rabe
Update in chronic obstructive pulmonary disease 2005.
Am. J. Respir. Crit. Care Med., May 15, 2006; 173(10): 1056 - 1065.
[Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
J. A. Wedzicha and T. Wilkinson
Impact of Chronic Obstructive Pulmonary Disease Exacerbations on Patients and Payers
Proceedings of the ATS, May 1, 2006; 3(3): 218 - 221.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
J. A. Wedzicha
Heliox in chronic obstructive pulmonary disease: lightening the airflow.
Am. J. Respir. Crit. Care Med., April 15, 2006; 173(8): 825 - 826.
[Full Text] [PDF]

Home page
 ChestHome page
F. Pitta, T. Troosters, V. S. Probst, M. A. Spruit, M. Decramer, and R. Gosselink
Physical Activity and Hospitalization for Exacerbation of COPD
Chest, March 1, 2006; 129(3): 536 - 544.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
E Sapey and R A Stockley
COPD exacerbations {middle dot} 2: Aetiology.
Thorax, March 1, 2006; 61(3): 250 - 258.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
G C Donaldson and J A Wedzicha
COPD exacerbations {middle dot} 1: Epidemiology
Thorax, February 1, 2006; 61(2): 164 - 168.
[Abstract] [Full Text] [PDF]

Home page
 Chronic Respiratory DiseaseHome page
M. A Spruit
Enhanced physiotherapy management of acute exacerbations of chronic obstructive pulmonary disease
Chronic Respiratory Disease, July 1, 2005; 2(3): 117 - 119.
[PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 2004 American Thoracic Society 		  Red In Translatin