Distribution of self-rated health and association with clinical parameters in patients with chronic obstructive pulmonary disease.

backgroundData on self-rated health (SRH) in patients with chronic obstructive pulmonary disease (COPD) are very limited; we therefore initiated this study to investigate the distribution of SRH and association with established parameters of disease severity. PATIENTS AND

methodsWe included 135 clinically stable patients with COPD (64 +/- 8 years, 71% men, GOLD stage: II -59; III -55; IV -21) and 25 healthy control persons. SRH was evaluated using the 5-grade Likert scale (1-very poor to 5-very good).

resultsPatients with COPD had poorer SRH when compared with controls (3.0 +/- 0.7 vs. 3.8 +/- 0.6, P < 0.001). SRH decreased over GOLD stage (P = 0.016) and 27 (20%) patients reported poor or very poor SRH. In univariate analysis, GOLD stage (P = 0.022), Center for Epidemiologic Studies Depression (CES-D) score (P = 0.001), BODE index score (P < 0.001), score on the modified Medical Research Council (MMRC) dyspnea scale (P < 0.001) and 6-minute walk test (6MWT) distance (P < 0.001) determined poor or very poor SRH. In a multivariate model which included BODE index score, a CES-D score > or = 16 (P = 0.013) and BODE index score (P = 0.012) determined poor or very poor SRH. In the model with individual components of the BODE index, a CES-D score > or = 16 (P = 0.012), MMRC score of 3 or 4 (P = 0.019) and 6MWT distance < or = 249 m (P = 0.019) determined poor or very poor SRH.

conclusionIn patients with COPD, SRH is worse than in healthy control persons and deteriorates over GOLD stage. Perception of health as poor or very poor is associated with psychological components (CES-D score) and disease severity (BODE index score, 6MWT distance and MMRC dyspnea score).