Chest
Volume 111, Issue 1, January 1997, Pages 95-98
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Clinical Investigations: COPD
Clinical and Personality Profiles and Survival in Patients With COPD

https://doi.org/10.1378/chest.111.1.95Get rights and content

Objective

To assess the relationship of personality and clinical characteristics with survival in patients with advanced chronic obstructive pulmonary disease (COPD).

Design

Prospective double-blind study.

Setting

Outpatient clinic of a teaching Veterans Affairs Hospital in central New York.

Patient participation

Sixteen male patients (mean age, 62.2±2.5 years) with severe COPD Interventions: Patients were administered Minnesota Multiphasic Personality Inventory (MMPI) test; their clinical features were recorded from hospital records at the time of admission into the study. All were followed up for 4 years after the initial assessment or until their death.

Measurements and main results

The nine survivors and seven nonsurvivors were similar in age, pulmonary function test (PFT) results, oxygenation, number of medications, or concomitant illnesses. However, the nonsurvivors had higher MMPI and clinical illness scores compared with the survivors (p<0.01 and <0.05, respectively).

Conclusions

The 4-year mortality in male veterans with severe COPD is influenced by overall psychological distress and difficulty in coping with their disease, which seem to be important prognostic indicators irrespective of PFT results or oxygenation.

Section snippets

MATERIALS AND METHODS

Sixteen male veterans with stable COPD regularly attending the Pulmonary Medicine Clinic at Syracuse (NY) Veterans Affairs (VA) Medical Center for many years were recruited for the study. All subjects had had routine laboratory and clinical investigations in the course of their treatment and no additional tests were obtained specifically for the purposes of this study.

Twenty-five consecutive FEV1 and FVC records were retrieved on the day of the recruitment and the rates of fall of these two

RESULTS

At the end of 4 years, nine subjects were alive (survivors) and seven died (nonsurvivors). All nonsurvivors died of respiratory failure and/or respiratory complications.

The values of selected variables in the two groups are shown in Table 2. Tables 3 and 4 summarize regularly used medications and concomitant illnesses other than COPD in the patients studied. The survivors and nonsurvivors were similar in the initial pulmonary function test results, age, duration of illness, and oxygen

DISCUSSION

Our results from this prospective double-blind study in patients with severe COPD show a significant difference in MMPI scores between those who died and those who were alive at the end of 4 years of follow-up irrespective of the degree of impairment in pulmonary function or oxygenation. A CS derived from easily obtained quantifiable objective data from the medical records also predicts mortality within 4 years with good reliability. The clinical and MMPI scores seem to be independent of each

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Abstract of this work was presented at the 61st Annual International Scientific Assembly of the American College of Chest Physicians, October 31, 1995.

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