Factors Associated with Severity of Dyspnea in Patients with Chronic Obstructive Pulmonary Disease in Zhejiang Province, China: A Cross-sectional Study
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Abstract
Introduction: Chronic obstructive pulmonary disease (COPD) is a chronic, progressive, and debilitating disease that causes dyspnea. Many factors are closely associated with the severity of dyspnea among COPD patients. The study aimed to assess the severity of dyspnea among COPD patients and determine the factors related to low symptom severity of dyspnea in Zhejiang Province, China.
Methods: An analytical cross-sectional study was conducted to collect data in the Zhejiang tertiary hospitals. A validated questionnaire was used to collect the clinical characteristics, demographics, medical histories, and laboratory results of participants. The modified Medical Research Council (mMRC) scale, was utilized to measure the severity of dyspnea. The questionnaires were completed via face-to-face and phone interviews. Binary logistic regression was applied to predict factors associated with low symptom severity of dyspnea among COPD patients at a significance level of α = 0.05.
Results: A total of 420 participants, selected by random sampling, were enrolled in this study. About 36.2% of the participants had low symptom severity of dyspnea. Those who were employed were 2.26 times more likely (95% CI = 1.01-5.09) to have low symptom severity than those who were unemployed. Those with an annual income greater than CNY 100,000 were 3.09 times more likely (95% CI=1.32-7.23) to have low symptom severity than those with an annual income less than CNY 100,000. Those whose COPD treatment cost less than CNY 5,000 per year were 4.39 times more likely (95% CI = 1.53-12.61) to have low symptom severity than those whose COPD treatment cost more than CNY 5,000 per year. Those with mild and moderate airflow limitation had a 6.39-fold (95% CI = 1.94-21.00) higher chance of having low symptom severity than those with severe and very severe airflow limitation. Those with less than 60 months of illness had a 7.02-fold (95% CI = 1.70-28.98) higher chance of experiencing low symptom severity than those with more than 120 months of illness. Those who had not been hospitalized in the past 3 months were 7.91 times more likely (95% CI = 1.37-45.73) to have low symptom severity than those who had been hospitalized more than twice in the past 3 months.
Conclusion: The results showed that the severity of dyspnea among COPD patients was strongly related to duration of illness, airflow limitation severity and the cost of COPD treatment. Early detection and treatment, including exacerbation strategies, are crucial to reducing the severity of dyspnea.
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