Changes and Clinical Consequences of Smoking Cessation in Patients With COPD A Prospective Analysis From the CHAIN Cohort
Por:
Martinez-Gonzalez, C, Casanova, C, de-Torres, J, Marin, J, de Lucas, P, Fuster, A, Cosio, B, Calle, M, Peces-Barba, G, Solanes, I, Aguero, R, Feu-Collado, N, Alfageme, I, Romero Plaza, A, Balcells, E, de Diego, A, Marin Royo, M, Moreno, A, Llunell Casanovas, A, Galdiz, J, Golpe, R, Lacarcel Bautista, C, Cabrera, C, Marin, A, Soriano, J and Luis Lopez-Campos, J
Publicada:
1 ago 2018
Resumen:
BACKGROUND: Despite the existing evidence-based smoking cessation interventions, chances of achieving that goal in real life are still low among patients with COPD. We sought to evaluate the clinical consequences of changes in smoking habits in a large cohort of patients with COPD.
METHODS: CHAIN (COPD History Assessment in Spain) is a Spanish multicenter study carried out at pulmonary clinics including active and former smokers with COPD. Smoking status was certified by clinical history and co-oximetry. Clinical presentation and disease impact were recorded via validated questionnaires, including the London Chest Activity of Daily Living (LCADL) and the Hospital Anxiety and Depression Scale (HADS). No specific smoking cessation intervention was carried out. Factors associated with and clinical consequences of smoking cessation were analyzed by multivariate regression and decision tree analyses.
RESULTS: One thousand and eighty-one patients with COPD were included (male, 80.8%; age, 65.2 [SD 8.9] years; FEV1, 60.2 [20.5]%). During the 2-year follow-up time (visit 2, 906 patients; visit 3, 791 patients), the majority of patients maintained the same smoking habit. Decision tree analysis detected chronic expectoration as the most relevant variable to identify persistent quitters in the future, followed by an LCADL questionnaire (cutoff 9 points). Total anxiety HADS score was the most relevant clinical impact associated with giving up tobacco, followed by the LCADL questionnaire with a cutoff value of 10 points.
CONCLUSIONS: In this real-life prospective COPD cohort with no specific antismoking intervention, the majority of patients did not change their smoking status. Our study also identifies baseline expectoration, anxiety, and dyspnea with daily activities as the major determinants of smoking status in COPD.
Filiaciones:
Martinez-Gonzalez, C:
Hosp Univ Cent Asturias, Dept Resp Med, Oviedo, Spain
Casanova, C:
Univ La Laguna, Hosp Univ Nuestra Senora Candelaria, Dept Resp Med, Tenerife, Spain
de-Torres, J:
Clin Univ Navarra, Dept Resp Med, Pamplona, Spain
Marin, J:
Hosp Univ Miguel Servet IISAragon, Dept Resp Med, Zaragoza, Spain
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Resp, CIBERES, Senora de Candelaria, Spain
de Lucas, P:
Fdn Invest Biomed Gregorio Maranon, Hosp Gregorio Maranon, Dept Resp Med, Madrid, Spain
Fuster, A:
Hosp Son Llatzer, Dept Resp Med, Palma De Mallorca, Spain
Cosio, B:
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Resp, CIBERES, Senora de Candelaria, Spain
Hosp Univ Son Espases, IdISBa, CIBERES, Dept Resp Med, Palma De Mallorca, Spain
Calle, M:
Hosp Clin San Carlos, Dept Resp Med, Madrid, Spain
Univ Complutense Madrid, Fac Med, Dept Med, Madrid, Spain
Peces-Barba, G:
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Resp, CIBERES, Senora de Candelaria, Spain
Hosp Univ Fdn Jimenez Diaz, Dept Resp Med, Madrid, Spain
Solanes, I:
Univ Autonoma Barcelona, Hosp Santa Creu & San Pau, Resp Dept, Barcelona, Spain
Aguero, R:
Hosp Univ Marques Valdecilla, Pulm Dept, Santander, Spain
Feu-Collado, N:
Univ Cordoba, Pulm Dept, Inst Maimonides Invest Biomed Cordoba, Hosp Univ Reina Sofia, Cordoba, Spain
Alfageme, I:
Univ Seville, Hosp Univ Valme, Pulm Dept, Seville, Spain
Romero Plaza, A:
Hosp Manacor, Pulm Dept, Manacor, Islas Baleares, Spain
Balcells, E:
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Resp, CIBERES, Senora de Candelaria, Spain
Hosp del Mar, Pulm Dept, Barcelona, Spain
de Diego, A:
Hosp Univ & Politecn la Fe, Pulm Dept, Valencia, Spain
:
Hosp Gen Castellon, Pulm Dept, Castellon de La Plana, Spain
Moreno, A:
Hosp Parc Tauli, Pulm Dept, Barcelona, Spain
Llunell Casanovas, A:
Hosp Tarrasa, Pulm Dept, Tarrasa, Spain
Galdiz, J:
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Resp, CIBERES, Senora de Candelaria, Spain
Hosp Univ Cruces, Pulm Dept, Bilbao, Spain
Golpe, R:
Hosp Univ Lucus Augusti, Pulm Dept, Lugo, Spain
Lacarcel Bautista, C:
Hosp Ciudad Jaen, Pulm Dept, Jaen, Spain
Cabrera, C:
Hosp Univ Gran Canaria Doctor Negrin, Pulm Dept, Las Palmas Gran Canaria, Spain
Marin, A:
Hosp Badalona Germans Trias & Pujol, Pulm Dept, Barcelona, Spain
Soriano, J:
Univ Autonoma Madrid, Inst Invest, Inst Invest Sanitaria Hosp Princesa, Hosp Univ Princesa, Madrid, Spain
Luis Lopez-Campos, J:
Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Resp, CIBERES, Senora de Candelaria, Spain
Univ Seville, Hosp Univ Virgen del Rocio, Unidad Med Quirurg Enfermedades Resp, Inst Biomed Sevilla IBiS,CIBERES, Seville, Spain
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