The Correlative Analysis Of Occurrence Of Anxiety/depression And Factors Associated With Acute Exacerbation In Patients With Stable Chronic Obstructive Pulmonary Disease

Objective:This study was designed to screen for anxiety and depression in patients with stable chronic obstructive pulmonary disease(COPD)and identified the risk factors for COPD with anxiety and depression.In addition,the factors related to acute exacerbation in patients with COPD during 6 months were studied as well.Methods:A prospective study was conducted by collecting the patients with COPD who were admitted to the Department of Respiratory and Critical Care Medicine of the First Affiliated Hospital of Nanchang University from June I,2017 to September 31,2017 Patients who met the inclusion criteria were included in this study.And the patients were divided into four groups based on the comprehensive assessment of GOLD 2017:low risk and less symptom group(group A),low risk multiple symptomatic group(group B),high risk and less symptomatic group(group C),and high risk multiple symptomatic group(group D).In addition,the General Hospital Anxiety/Depression Sentiment Chart(HADS)was used to assess anxiety and depression,respectively.And further analysis of the relationship between anxiety/depression and the gender,age,body mass index(BMI),marital status,education level,smoking status,comorbidity index(CCI),duration of disease,severity of symptoms(CAT score),frequency of acute exacerbation,grading of dyspnea(mMRC),percentage of forced expiratory volume in the first second as a percentage of predicted value(FEV1%predicted value)and so on.Moreover,the above patients were followed up for acute exacerbation during 6 months.Results:A total of 141 patients with COPD were recruited,with an average age of 65.30±7.29 years and 83%male.Among them,30 were anxious(21.7%),38 were depressed(27%),and 24 were anxious and depressed(17%).The results suggested that the incidence of anxiety and depression was associated with mMRC score,CAT score,gender,smoking history and acute aggravation history(P<0.05).And multivariate regression analysis showed that female and the patients with high CAT scores were independent risk factors for depression.Besides,the incidence of acute exacerbation during the 6 months(60.3%),was related to mMRC score,CAT score,BMI,FEVI%,anxiety,depression,frequency of acute exacerbation and multivariate regression analysis showed that a history of frequent acute exacerbation history(OR 7.83;95%CI 3.00-20.48,P<0.001)and malnutrition(BMI<18.5)(OR 6.46;95%CI 1.04-40.02,P P 0.045)were independent risk factors for acute exacerbation a history of in the short-term.Conclusion:All in all,this study demonstrated that patients with stable COPD have a higher rate of anxiety or depression.Female and high CAT scores,in particular,were two independent risk factors in patients with COPD and depression.What’s more,Malnutrition and a history of frequent acute exacerbations were independent risk factors for acute exacerbations of COPD patients in the short-term.