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The relationship between body mass index and health-related quality of life in COPD: Real-world evidence based on claims and survey data.
Respir. Res. 21:291 (2020)
Background Body mass index (BMI) is an important parameter associated with mortality and health-related quality of life (HRQoL) in chronic obstructive pulmonary disease (COPD). However, informed guidance on stratified weight recommendations for COPD is still lacking. This study aims to determine the association between BMI and HRQoL across different severity grades of COPD to support patient management. Methods We use conjunct analysis of claims and survey data based on a German COPD disease management program from 2016 to 2017. The EQ-5D-5L visual analog scale (VAS) and COPD Assessment Test (CAT) are used to measure generic and disease-specific HRQoL. Generalized additive models with smooth functions are implemented to evaluate the relationship between BMI and HRQoL, stratified by COPD severity. Results 11,577 patients were included in this study. Mean age was 69.4 years and 59% of patients were male. In GOLD grades 1-3, patients with BMI of around 25 had the best generic and disease-specific HRQoL, whereas in GOLD grade 4, obese patients had the best HRQoL using both instruments when controlled for several variables including smoking status, income, COPD severity, comorbidities, emphysema, corticosteroid use, and days spent in hospital. Conclusion This real-world analysis shows the non-linear relationship between BMI and HRQoL in COPD. HRQoL of obese patients with mild to severe COPD might improve following weight reduction. For very severe COPD, a negative association of obesity and HRQoL could not be confirmed. The results hint at the need to stratify COPD patients by disease stage for optimal BMI management.
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Publication type
Article: Journal article
Document type
Scientific Article
Keywords
Copd ; Bmi ; Health-related Quality Of Life ; Obesity ; Real-world Evidence; Obstructive Pulmonary-disease; All-cause Mortality; Bariatric Surgery; Nutritional-status; Obesity Paradox; Association; Management; Emphysema; Outcomes; Bmi
ISSN (print) / ISBN
1465-9921
e-ISSN
1465-993X
Journal
Respiratory Research
Quellenangaben
Volume: 21,
Issue: 1,
Article Number: 291
Publisher
BioMed Central
Publishing Place
Campus, 4 Crinan St, London N1 9xw, England
Non-patent literature
Publications
Reviewing status
Peer reviewed
Grants
Federal Joint Committee (G-BA), Germany
Projekt DEAL
Projekt DEAL