Authors (including presenting author) :
Mo KC(1), Tse YW(1), Ng MW(1), Tsang HC(1), To YL(1), Choo KL(2)
Affiliation :
(1)Physiotherapy Department, North District Hospital (NDH)
(2)Department of Medicine, North District Hospital (NDH)
Introduction :
Dyspnea is a major cause of physical and emotional issues in people with chronic obstructive pulmonary disease (COPD) and is a subjective experience that comprises physical and affective components. To manage dyspnea more accurately, precise assessment is needed. The Chinese version of Dyspnoea‐12 (D‐12) scale has been validated with acceptable reliability in measuring different dimensions of dyspnea. Factors associated with the scale were analyzed to determine the formulation of an effective treatment plan.
Objectives :
To evaluate the association between functional exercise capacity, COPD stage, and the perceived severity of dyspnea in patients with COPD, and to identify the predictors of dyspnea perception in post- exacerbation and stable COPD cases.
Methodology :
Clinical data of patients who attended NDH COPD clinic in 2024 was analyzed retrospectively. The results of D-12, 6-minute walk test (6MWT), GOLD stage and modified Medical Research Council Dyspnea Score (mMRC) were retrieved with statistical analyses by IBM SPSS Statistics for Windows, Version 28.0.
Result & Outcome :
A total of 40 post-COPD exacerbation cases were referred from in-patient and 81 stable COPD cases were referred from the special out-patient clinic. The mean D-12 scores were 4.8±6.3 for post-exacerbation cases and 7.8±7.3 for stable cases (p=0.035). In the post-hospitalization group, multiple linear regression was used to predict D-12 scores from disease stage (GOLD stage) and functional exercise capacity (6MWT). The multiple R (0.593) was statistically significant (p=0.007). Both GOLD stage (p=0.017) and 6MWT (p=0.009) are significant predictors of D-12 scores and accounted for 35.2% variance in D-12 scores. According to the standardized regression coefficients, 6MWT (-0.489) is a stronger predictor of D-12 scores than the GOLD stage (-0.441). Those with higher 6MWT distance coverage tend to have lower D-12 scores. In the stable COPD group, multiple linear regression was used to predict D-12 scores from the same variables plus severity of dyspnea (mMRC). The multiple R (0.413) was statistically significant (p=0.005). Only mMRC (p=0.005) is a significant predictor of D-12 scores and accounted for 17.1% variance in D-12 scores, neither GOLD stage nor 6MWT are significant predictors in this group. Those with higher mMRC stage tend to have higher D-12 scores. To conclude, enhancing functional exercise capacity may be beneficial for post-exacerbation COPD cases in improving their perception of dyspnea. On the other hand, stable COPD cases may benefit from appropriate psychological inputs, enabling for a better cope with their symptoms and maintain a stable condition.
