Sputum microbiology predicts health status in COPD

Spontaneous sputum production occurs in a subset of COPD patients; however, its clinical relevance has not been established. Differences in health status and clinical outcomes between patients with and without positive sputum cultures are unknown. To compare clinical characteristics and health statu...

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Bibliographic Details
Published in:International journal of chronic obstructive pulmonary disease Vol. 11; no. 1; pp. 2741 - 2748
Main Authors: Braeken, Dionne, Houben-Wilke, Sarah, Smid, Dionne, Rohde, Gernot, Drijkoningen, Jesse, Wouters, Emiel, Spruit, Martijn, Franssen, Frits
Format: Journal Article
Language:English
Published: New Zealand Dove Medical Press Limited 2016
Dove Medical Press Ltd
Dove Medical Press
Subjects:
Aged
Anxiety
Bronchitis
Care and treatment
Chronic obstructive pulmonary disease
COPD
Development and progression
Disease Progression
Exercise Tolerance
Female
Forced Expiratory Volume
Health aspects
Health Status
Hospitals
Humans
Lung - microbiology
Lung - physiopathology
Lung diseases
Lung diseases, Obstructive
Male
Medical research
Microbiology
Middle Aged
Mortality
Netherlands
Original Research
Patients
Predictive Value of Tests
Prognosis
Pulmonary Disease, Chronic Obstructive - diagnosis
Pulmonary Disease, Chronic Obstructive - microbiology
Pulmonary Disease, Chronic Obstructive - physiopathology
Pulmonary Disease, Chronic Obstructive - therapy
pulmonary rehabilitation
Quality of life
Questionnaires
Respiratory Tract Infections - diagnosis
Respiratory Tract Infections - microbiology
Respiratory Tract Infections - physiopathology
Respiratory Tract Infections - therapy
Risk Factors
Severity of Illness Index
Sputum
Sputum - microbiology
Surveys and Questionnaires
Testing
Variance analysis
Walk Test
health status
microbiology
sputum
pulmonary rehabilitation
COPD
ISSN:1178-2005, 1176-9106, 1178-2005
Online Access:Get full text
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Summary:Spontaneous sputum production occurs in a subset of COPD patients; however, its clinical relevance has not been established. Differences in health status and clinical outcomes between patients with and without positive sputum cultures are unknown. To compare clinical characteristics and health status of spontaneous sputum producers with a positive culture (SC+) and negative culture (SC-) with nonsputum producers (NP) in a cohort of COPD patients referred for pulmonary rehabilitation. In total, 518 clinically stable patients with mild-to-very severe COPD were recruited (mean age: 64.1±9.1 years, 55.6% males, forced expiratory volume in 1 second 48.6%±20.0% predicted). Health status was measured using COPD Assessment Test, St George's Respiratory Questionnaire, and the Clinical COPD Questionnaire. Symptoms of anxiety and depression were assessed using the Hospital Anxiety and Depression Scale. Exercise capacity was measured using the 6-minute walking distance. Spontaneously expectorated sputum was cultured for microbiology. Almost one-third of patients spontaneously produced sputum (n=164, 31.7%). Despite comparable lung function, SC+ reported more frequent exacerbations than NP (≥2 exacerbations <1 year: 43 [81.1%] vs 179 [50.6%], <0.001). COPD Assessment Test total score and the Clinical COPD Questionnaire total score were significantly worse in SC+ than NP (23.9±6.1 vs 21.1±6.7, =0.012; 3.1±1.0 vs 2.5±1.0, =0.002; respectively). Hospital Anxiety and Depression Scale-D score was significantly higher in SC+ than NP (8.7±4.1 vs 7.2±4.3, =0.046). Spontaneous sputum production is common in COPD. Particularly, patients with positive cultures have worse health status and more symptoms of depression. Impact on disease progression and long-term outcomes remain to be established. NTR3416, registered at www.trialregister.nl.
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ISSN:1178-2005
1176-9106
1178-2005
DOI:10.2147/COPD.S117079