Potential risk stratification of patients with chronic obstructive pulmonary disease based on patient-reported outcomes
Aim:To explore potential risk stratification of patients with chronic obstructive pulmonary disease(COPD)based on patient-reported outcomes.Methods:A questionnaire survey was conducted on 474 COPD patients from 13 hospi-tals in Taiyuan city by convenience sampling method.With the scores of physiological,psychological and social domains in the COPD-Patient Reported Outcomes Management as explicit variables,latent profile analysis(LPA)was performed to i-dentify potential risk stratification in COPD patients.Logistic regression analysis was carried out with the potential risks in physiological,psychological and social domains as dependent variables,and the features after single factor screening as inde-pendent variables.Results:According to LPA,there were 3 potential risks in the physiological domain.Among 474 COPD patients,low specific symptoms(SPE),low independence(IND),high general symptoms(GEN)accounted for 40%.The proportion of medium SPE,medium IND,medium GEN was 43%,and that of high SPE,high IND,low GEN was 17%.The patients who had quit smoking or were workers were more likely to develop medium SPE,medium IND,medium GEN than low SPE,low IND,high GEN,OR(95%CI)was 2.909(1.025-8.255)and 1.968(1.119-3.460).The psychological domain supported two potential risks.The low mental quality accounted for 53%among 474 cases,and the high mental qual-ity accounted for47%.Patients without family history of COPD had higher mental quality,OR(95%CI)was1.871(1.117-3.135).Three potential risks were supported in the social domain.In474 cases,the low cognition(COG),high influence(INF),high social support(SUP)accounted for 44%,medium COG,medium INF,medium SUP accounted for 26%,and high COG,low INF,low SUP accounted for 30%.The probability of medium COG,medium INF,medium SUP and high COG,low INF,low SUP was higher in intellectuals,OR(95%CI)was 2.816(1.084-7.316)and 3.185(1.131-8.972);farmers,workers and managers were more likely to have high COG,low INF,low SUP,OR(95%CI)was 2.300(1.156-4.579),4.092(2.058-8.136),3.387(1.395-8.220).Conclusion:This study has realized the risk stratifi-cation of COPD patients in physiological,psychological and social domains respectively,providing a new basis for disease classification management.
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