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International Journal of Chronic Obstructive Pulmonary Disease Volume 15, 2020 - Issue
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Original Research

The Relationship Between Morning Symptoms and the Risk of Future Exacerbations in COPD

Tian Sun1 Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan410011, People’s Republic of China;2 Research Unit of Respiratory Disease, Central South University, Central South University, Changsha, Hunan410011, People’s Republic of China
,
Xiaoyun Li3 Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong510000, People’s Republic of China
,
Wei Cheng1 Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan410011, People’s Republic of China;2 Research Unit of Respiratory Disease, Central South University, Central South University, Changsha, Hunan410011, People’s Republic of ChinaORCID Iconhttps://orcid.org/0000-0003-1025-0591
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Yating Peng1 Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan410011, People’s Republic of China;2 Research Unit of Respiratory Disease, Central South University, Central South University, Changsha, Hunan410011, People’s Republic of ChinaORCID Iconhttps://orcid.org/0000-0001-8084-8471
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Yiyang Zhao1 Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan410011, People’s Republic of China;2 Research Unit of Respiratory Disease, Central South University, Central South University, Changsha, Hunan410011, People’s Republic of ChinaORCID Iconhttps://orcid.org/0000-0001-5975-8025
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Cong Liu1 Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan410011, People’s Republic of China;2 Research Unit of Respiratory Disease, Central South University, Central South University, Changsha, Hunan410011, People’s Republic of China
,
Yuqin Zeng1 Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan410011, People’s Republic of China;2 Research Unit of Respiratory Disease, Central South University, Central South University, Changsha, Hunan410011, People’s Republic of China
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Yan Chen1 Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan410011, People’s Republic of China;2 Research Unit of Respiratory Disease, Central South University, Central South University, Changsha, Hunan410011, People’s Republic of China
,
Shan Cai1 Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan410011, People’s Republic of China;2 Research Unit of Respiratory Disease, Central South University, Central South University, Changsha, Hunan410011, People’s Republic of China
&
Ping Chen1 Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan410011, People’s Republic of China;2 Research Unit of Respiratory Disease, Central South University, Central South University, Changsha, Hunan410011, People’s Republic of ChinaCorrespondence[email protected]
ORCID Iconhttps://orcid.org/0000-0001-6707-8636
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Pages 1899-1907 | Published online: 05 Aug 2020

Figures & data

Figure 1 Study flow diagram.

Figure 1 Study flow diagram.

Table 1 Baseline Characteristics

Figure 2 Morning symptom score in COPD GOLD A, B, C and D groups. COPD GOLD A (n=12), B (n=35), C (n=4) and D (n=41). Data were compared between groups using the Kruskal–Wallis H-test.

Abbreviations: GOLD, Global Initiative for Chronic Obstructive Lung Disease; Ch-COPD-MSD, Chinese-version of chronic obstructive pulmonary disease morning symptom diary.
Figure 2 Morning symptom score in COPD GOLD A, B, C and D groups. COPD GOLD A (n=12), B (n=35), C (n=4) and D (n=41). Data were compared between groups using the Kruskal–Wallis H-test.

Figure 3 Association of morning symptom and clinical characteristics in COPD patients. (A) Comparison of baseline mMRC score between the two groups. (B) Comparison of baseline CAT score between the two groups. (C) Comparison of baseline CCQ score between the two groups. Data were compared between groups using the Mann–Whitney U-test and t-test.

Abbreviations: mMRC, Modified Medical Research Council Dyspnea Scale; CAT, COPD assessment test; CCQ, Clinical COPD questionnaire.
Figure 3 Association of morning symptom and clinical characteristics in COPD patients. (A) Comparison of baseline mMRC score between the two groups. (B) Comparison of baseline CAT score between the two groups. (C) Comparison of baseline CCQ score between the two groups. Data were compared between groups using the Mann–Whitney U-test and t-test.

Table 2 Associations Between Clinical Characteristics and Morning Symptoms Severity According to Multiple Linear Regression Analysis

Figure 4 Correlation between morning symptom and clinical characteristics. (A) Correlation between Ch-COPD-MSD score and FEV1% predicted in COPD patients. (B) Correlation between Ch-COPD-MSD score and mMRC score in COPD patients. (C) Correlation between Ch-COPD-MSD score and CAT score in COPD patients. (D) Correlation between Ch-COPD-MSD score and CCQ score in COPD patients. Correlations between continuous variables were evaluated using Spearman’s rank correlation coefficient.

Abbreviations: FEV1% predicted, forced expiratory volume in one second as a percentage of the predicted value; mMRC, Modified Medical Research Council Dyspnea Scale; CAT, COPD assessment test; CCQ, Clinical COPD questionnaire; Ch-COPD-MSD, Chinese-version of chronic obstructive pulmonary disease morning symptom diary.
Figure 4 Correlation between morning symptom and clinical characteristics. (A) Correlation between Ch-COPD-MSD score and FEV1% predicted in COPD patients. (B) Correlation between Ch-COPD-MSD score and mMRC score in COPD patients. (C) Correlation between Ch-COPD-MSD score and CAT score in COPD patients. (D) Correlation between Ch-COPD-MSD score and CCQ score in COPD patients. Correlations between continuous variables were evaluated using Spearman’s rank correlation coefficient.

Table 3 The Relationship Between Morning Symptoms and the Exacerbations of the One-Year Follow-Up Period

Figure 5 The ROC curve of severe exacerbation of COPD patients was predicted by Ch-COPD-MSD score.

Abbreviations: Ch-COPD-MSD, Chinese-version of chronic obstructive pulmonary disease morning symptom diary; ROC, receiver operating characteristic.
Figure 5 The ROC curve of severe exacerbation of COPD patients was predicted by Ch-COPD-MSD score.

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