A New Dyspnea Evaluation System Focusing on Patients’ Perceptions of Dyspnea and Their Living Disabilities: The Linkage between COPD and Frailty
Keiji Oishi, Kazuto Matsunaga, Misa Harada, Junki Suizu, Keita Murakawa, Ayumi Chikumoto, Yuichi Ohteru, Kazuki Matsuda, Sho Uehara, Kazuki Hamada, Shuichiro Ohata, Yoriyuki Murata, Yoshikazu Yamaji, Maki Asami‐Noyama, Nobutaka Edakuni, Tomoyuki Kakugawa, Tsunahiko Hirano
Abstract
BACKGROUND: As much as there are unmet needs for brief frailty assessment in patients with chronic obstructive pulmonary disease (COPD), the lack of a simplified and comprehensive dyspnea evaluation system that focuses on the patients' perceptions of dyspnea and their COPD living disabilities remains a major challenge. We developed patient-reported outcome measures for dyspnea-related behavior and activity limitation (PROMs-D), which consisted of the Activity-limit Dyspnea Scale (ADS) and Self-Limit Dyspnea Scale (SDS), while investigated the usefulness of PROMs-D in identifying frailty. METHODS: We administered PROMs-D and frailty status evaluations in 128 outpatients. RESULTS: < 0.001), and both ADS and SDS had high accuracies for detecting frailty (AUC, 0.82 and 0.78, respectively). Moreover, a PROMs-D score that consisted of the sum of ADS and SDS was more effective in stratifying frailty (cutoff value, 2; AUC, 0.85; sensitivity, 60%; specificity, 95%). CONCLUSIONS: PROMs-D could be used as the first step for frailty screening in patients with COPD, and we propose the importance of capturing the troublesome nature of living behaviors due to dyspnea in daily clinical practice.