scholarly journals New versus old guidelines for sarcopenia classification: What is the impact on prevalence and health outcomes?

2019 ◽  
Author(s):  
Fanny Petermann-Rocha ◽  
Minghao Chen ◽  
Stuart R Gray ◽  
Frederick K Ho ◽  
Jill P Pell ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Respiratory Disease ◽  
Operational Definition ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Incidence And Mortality ◽  
European Working ◽  
All Cause Mortality ◽  
The Uk ◽  
The Impact

Abstract Introduction recently, the European Working Group on Sarcopenia in Older People (EWGSOP) established a new operational definition and cut-off points for sarcopenia. The aim of this study was, therefore, to compare the prevalence of sarcopenia and its associations with different health outcomes using the old (EWGSOP1) and new (EWGSOP2) definitions of sarcopenia in the UK Biobank cohort. Methods sarcopenia was defined as low grip strength plus low muscle mass. Using both EWGSOP cut-off points, we created specific sarcopenia variables. Prevalence of sarcopenia derived using both EWGSOP definitions was calculated and compared as well as prospective health outcomes including all-cause mortality as well as incidence and mortality from cardiovascular disease (CVD), respiratory disease and chronic obstructive pulmonary disease (COPD). Results the prevalence of sarcopenia based on the EWGSOP1 and EWGSOP2 classifications were 8.14 and 0.36%, respectively. Sarcopenia defined by EWGSOP1 was associated with a higher risk of respiratory disease and COPD as well as mortality from all-cause, CVD and respiratory diseases. However, only respiratory incidence remained associated with sarcopenia when EWGSOP2 was used (HR: 1.32 [95% CI: 1.05–1.66]). Moreover, although individuals classified as sarcopenic using both classifications had the highest risk of all-cause mortality and respiratory disease, those with sarcopenia based on EWGSOP1 only experienced a more extensive range of poorer health outcomes. Conclusion in comparison with EWGSOP1, the new classification (EWGSOP2) produced a lower estimate of sarcopenia prevalence and fewer associations with adverse health outcomes. Although these associations were higher, many become non-significant.

scholarly journals Tai Chi Movements for Wellbeing – evaluation of a British Lung Foundation pilot

2019 ◽  
Vol 140 (3) ◽  
pp. 172-180 ◽  
Author(s):  
A Lewis ◽  
NS Hopkinson
Keyword(s):  
Respiratory Disease ◽  
Tai Chi ◽  
Exercise Intervention ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Assessment Test ◽  
Qualitative Feedback ◽  
Improve Exercise Capacity ◽  
The Uk

Aims: In breathless individuals with respiratory disease, pulmonary rehabilitation (PR) can improve exercise capacity, symptoms and ability to cope with their condition. However, access is often limited, and adherence can be poor. Thus, there is interest in developing alternative and complementary forms of exercise intervention and tai chi may be effective in this context. Method: The British Lung Foundation worked in collaboration with ‘Tai Chi Movements for Wellbeing’ Training to train leaders to run community-based tai chi groups in the UK. Leaders received funding to run 3 months of once-a-week classes consisting of a 12 movement sequence of tai chi. Participants completed a questionnaire survey to evaluate the service at the start of their first session and again after 3 months. Results: Ten tai chi groups recruited 128 participants, 65% women, mean (standard deviation (SD)) age 70.1 (7.4) years at baseline. Seventy individuals completed the follow-up questionnaire at 3 months. Participants demonstrated an improvement in Medical Research Council (MRC) Dyspnoea Score pre 3 (interquartile range (IQR) = 1.8), post 2 (IQR = 1), p = .013 and disease burden; chronic obstructive pulmonary disease (COPD) assessment test score pre 19.4 (8.7), post 17.9 (9.4), mean change –1.5 (confidence interval (CI): –2.89 to –0.127), p = .033. Those who completed the programme had a worse baseline COPD assessment test (CAT) score and were more likely to have participated in maintenance exercise previously. Qualitative feedback suggested that participants felt the classes had helped with breathlessness and relaxation. Conclusion: Establishing a tai chi for wellbeing programme for people with respiratory disease is feasible, with a reasonable level of compliance, and is perceived to be helpful by participants.

scholarly journals Bronchiectasis and increased mortality in patients with corticosteroid-dependent severe asthma: a nationwide population study

2020 ◽  
Vol 14 ◽  
pp. 175346662096303
Author(s):  
Hayoung Choi ◽  
Hyun Lee ◽  
Jiin Ryu ◽  
Sung Jun Chung ◽  
Dong Won Park ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Respiratory Diseases ◽  
Chronic Obstructive ◽  
Study Cohort ◽  
Limited Information ◽  
Term Survival ◽  
Obstructive Pulmonary Disease ◽  
All Cause Mortality ◽  
The Impact

Background: Long-term corticosteroid (CS) use is associated with increased mortality in patients with asthma, and comorbid bronchiectasis is also associated with frequent asthma exacerbation and increased healthcare use. However, there is limited information on whether bronchiectasis further increases mortality in patients with CS-dependent asthma. This study examined the impact of bronchiectasis on mortality in patients with CS-dependent asthma. Methods: A retrospective cohort of patients with CS-dependent asthma ⩾18 years old was established using records from the Korean National Health Insurance Service database from 2005 to 2015. Patients with CS-dependent asthma with and without bronchiectasis were matched by age, sex, type of insurance, and Charlson comorbidity index. We evaluated the hazard ratio (HR) for all-cause mortality in patients with bronchiectasis compared with those without bronchiectasis. Results: The study cohort included 754 patients with CS-dependent asthma with bronchiectasis and 3016 patients with CS-dependent asthma without bronchiectasis. Patients with CS-dependent asthma with bronchiectasis had a higher all-cause mortality than those without bronchiectasis (8429/100,000 versus 6962/100,000 person-years, p < 0.001). The adjusted HR for mortality in patients with CS-dependent asthma with bronchiectasis relative to those without bronchiectasis was 1.33 (95% confidence interval, 1.18–1.50), and the association was primarily significant for respiratory diseases (subdistribution HR = 1.65, 95% confidence interval, 1.42–1.92). Conclusions: Bronchiectasis further increases all-cause mortality in patients with CS-dependent asthma, a trend that was especially associated with respiratory diseases including chronic obstructive pulmonary disease. Strategies to improve treatment outcomes in patients with CS-dependent asthma with bronchiectasis are urgently needed to improve long-term survival. The reviews of this paper are available via the supplemental material section.

scholarly journals Impact of COVID-19 lockdown on the incidence and mortality of acute exacerbations of chronic obstructive pulmonary disease: national interrupted time series analyses for Scotland and Wales

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Mohammad A. Alsallakh ◽  
◽  
Shanya Sivakumaran ◽  
Sharon Kennedy ◽  
Eleftheria Vasileiou ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Hospital Admissions ◽  
Interrupted Time Series ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Exacerbations ◽  
Time Series Analyses ◽  
The Uk ◽  
The Impact ◽  
Severe Copd

Abstract Background The COVID-19 pandemic and ensuing national lockdowns have dramatically changed the healthcare landscape. The pandemic’s impact on people with chronic obstructive pulmonary disease (COPD) remains poorly understood. We hypothesised that the UK-wide lockdown restrictions were associated with reductions in severe COPD exacerbations. We provide the first national level analyses of the impact of the COVID-19 pandemic and first lockdown on severe COPD exacerbations resulting in emergency hospital admissions and/or leading to death as well as those recorded in primary care or emergency departments. Methods Using data from Public Health Scotland and the Secure Anonymised Information Linkage Databank in Wales, we accessed weekly counts of emergency hospital admissions and deaths due to COPD over the first 30 weeks of 2020 and compared these to the national averages over the preceding 5 years. For both Scotland and Wales, we undertook interrupted time-series analyses to model the impact of instigating lockdown on these outcomes. Using fixed-effect meta-analysis, we derived pooled estimates of the overall changes in trends across the two nations. Results Lockdown was associated with 48% pooled reduction in emergency admissions for COPD in both countries (incidence rate ratio, IRR 0.52, 95% CI 0.46 to 0.58), relative to the 5-year averages. There was no statistically significant change in deaths due to COPD (pooled IRR 1.08, 95% CI 0.87 to 1.33). In Wales, lockdown was associated with 39% reduction in primary care consultations for acute exacerbation of COPD (IRR 0.61, 95% CI 0.52 to 0.71) and 46% reduction in COPD-related emergency department attendances (IRR 0.54, 95% CI 0.36 to 0.81). Conclusions The UK-wide lockdown was associated with the most substantial reductions in COPD exacerbations ever seen across Scotland and Wales, with no corresponding increase in COPD deaths. This may have resulted from reduced transmission of respiratory infections, reduced exposure to outdoor air pollution and/or improved COPD self-management.

Incidence, predictors and mortality risk of new heart failure in patients hospitalised with atrial fibrillation

Heart ◽  
2021 ◽  
pp. heartjnl-2020-318648
Author(s):  
Courtney Weber ◽  
Joseph Hung ◽  
Siobhan Hickling ◽  
Lee Nedkoff ◽  
Kevin Murray ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Mortality Risk ◽  
Integrated Management ◽  
Chronic Obstructive ◽  
Clinical Predictors ◽  
Obstructive Pulmonary Disease ◽  
Lifestyle Risk Factors ◽  
All Cause Mortality ◽  
The Impact

ObjectiveTo determine the incidence, risk predictors and relative mortality risk of incident heart failure (HF) in patients following atrial fibrillation (AF) hospitalisation.MethodsThe Western Australian Hospitalisation Morbidity Data Collection was used to identify patients aged 25–94 years with index (first-in-period) AF hospitalisation, but without a prior HF admission, between 2000 and 2013. We evaluated the risk of incident HF hospitalisation within 3 years after AF admission, and the impact of HF hospitalisation on all-cause mortality.ResultsThe cohort comprised 52 447 patients, 57.5% men, with a median age of 73.1 (IQR 63.2-80.8) years. At 3 years after AF discharge, the cumulative incidence of HF (n=6153) was 11.7% (95% CI 11.5% to 12.0%) and all-cause death (n=9702) was 18.5% (95% CI 18.2% to 18.8%). Independent predictors of incident HF included advancing age, any history of myocardial infarction (MI), peripheral vascular disease, valvular heart disease, chronic kidney disease, chronic obstructive pulmonary disease, hypertension, diabetes, obesity and excessive alcohol use (all p<0.001). Patients hospitalised for first-ever HF compared with those without HF hospitalisation had an adjusted HR of 3.3 (95% CI 3.1 to 3.4) for all-cause mortality (p<0.001). Independent predictors of HF were also shared with those for mortality, with the exception of hypertension.ConclusionHospitalisation for new HF is common in patients with AF and independently associated with a 3-fold hazard for death. The clinical predictors of incident HF emphasise the importance of integrated management of common comorbid conditions and lifestyle risk factors in patients with AF to reduce their morbidity and mortality.

scholarly journals Impact of smoking, COPD and comorbidities on the mortality of COVID-19 patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Donato Lacedonia ◽  
Giulia Scioscia ◽  
Carla Santomasi ◽  
Paolo Fuso ◽  
Giovanna Elisiana Carpagnano ◽  
...  
Keyword(s):  
Clinical Course ◽  
Current Data ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Former Smokers ◽  
Never Smokers ◽  
The Impact

AbstractThe prognosis of the coronavirus disease 2019 (COVID-19) patients is variable and depends on several factors. Current data about the impact of chronic obstructive pulmonary disease (COPD) and smoking on the clinical course of COVID-19 are still controversial. This study evaluated the prevalence and the prognosis of COPD patients and smokers in a cohort of 521 patients admitted to four intermediate Respiratory Intensive Care Units (Puglia, Italy) with respiratory failure due to COVID-19 pneumonia. The prevalence of COPD and current smokers was 14% and 13%, respectively. COPD patients had a higher 30-day all-cause mortality than non-COPD patients. Former smokers compared to never smokers and current smokers had higher 30-day all-cause mortality. COPD patients and former smokers had more comorbidities. This study described the prevalence and the outcomes of COPD patients and smokers in a homogenous cohort of COVID-19 patients. The study showed that the prevalence of COPD and current smokers was not high, suggesting that they were not at increased risk of getting the infection. However, when SARS-CoV-2 infection occurred, COPD patients and former smokers were those with the highest all-cause mortality, which seemed to be mainly related to the presence of comorbidities and not to COPD and smoking itself.

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