Deprivation is an independent predictor of 1-year mortality in outpatients with chronic obstructive pulmonary disease


Autoria(s): Collins, Peter F.; Stratton, Rebecca J.; Kurukulaaratchy, Ramesh; Elia, Marinos
Data(s)

2010

Resumo

Deprivation is linked to increased incidence in a number of chronic diseases but its relationship to chronic obstructive pulmonary disease (COPD) is uncertain despite suggestions that the socioeconomic gradient seen in COPD is as great, if not greater, than any other disease (Prescott and Vestbo).1 There is also a need to take into account the confounding effects of malnutrition which have been shown to be independently linked to increased mortality (Collins et al).2 The current study investigated the influence of social deprivation on 1-year survival rates in COPD outpatients, independently of malnutrition. 424 outpatients with COPD were routinely screened for malnutrition risk using the ‘Malnutrition Universal Screening Tool’; ‘MUST’ (Elia),3 between July and May 2009; 222 males and 202 females; mean age 73 (SD 9.9) years; body mass index 25.8 (SD 6.3) kg/m2. Each individual's deprivation was calculated using the index of multiple deprivation (IMD) which was established according to the geographical location of each patient's address (postcode). IMD includes a number of indicators covering economic, housing and social issues (eg, health, education and employment) into a single deprivation score (Nobel et al).4 The lower the IMD score, the lower an individual's deprivation. The IMD was assigned to each outpatient at the time of screening and related to1-year mortality from the date screened. Outpatients who died within 1-year of screening were significantly more likely to reside within a deprived postcode (IMD 19.7±SD 13.1 vs 15.4±SD 10.7; p=0.023, OR 1.03, 95% CI 1.00 to 1.06) than those that did not die. Deprivation remained a significant independent risk factor for 1-year mortality even when adjusted for malnutrition as well as age, gender and disease severity (binary logistic regression; p=0.008, OR 1.04, 95% CI 1.04 to 1.07). Deprivation was not associated with disease-severity (p=0.906) or body mass index, kg/m2 (p=0.921) using ANOVA. This is the first study to show that deprivation, assessed using IMD, is associated with increased 1-year mortality in outpatients with COPD independently of malnutrition, age and disease severity. Deprivation should be considered in the targeted management of these patients.

Identificador

http://eprints.qut.edu.au/52024/

Publicador

BMJ Publishing Group

Relação

DOI:10.1136/thx.2010.150953.16

Collins, Peter F., Stratton, Rebecca J., Kurukulaaratchy, Ramesh, & Elia, Marinos (2010) Deprivation is an independent predictor of 1-year mortality in outpatients with chronic obstructive pulmonary disease. Thorax, 65, A74-A75.

Direitos

Copyright 2010 BMJ Publishing Group

Fonte

Faculty of Health; School of Exercise & Nutrition Sciences

Palavras-Chave #110000 MEDICAL AND HEALTH SCIENCES #111700 PUBLIC HEALTH AND HEALTH SERVICES #Deprivation #Mortality #Chronic Obstructive Pulmonary Disease #COPD
Tipo

Journal Article