Page 43 - Livre électronique des RFTP 2023

P16. ANXIETY AND DEPRESSION A HALLMARK TO

PREDICT READMISSION FOR ACUTE EXACERBATION IN

PATIENTS WITH COPD

W. JELASSI, C. HABOURIA, N. BELLOUMI, I. BECHOUCH, F. CHERMITI, S. FENNICHE
PULMONOLOGYDEPARTMENTPAVILION IV, PULMONOLOGY HOSPITAL ABDERRAHMAN MAMI,
ARIANA, TUNISIA

INTRODUCTION : Anxiety and depression are common comorbidities of COPD.
Acute exacerbations of COPD (AECOPD) readmissions are an independent risk
factor for increased mortality and usage of health-care resources. The way in which
anxiety and depression may be associated with COPD exacerbations may also
have a relationship with this issue of ineffective coping and self-management
strategies adopted by the patients.

OBJECTIVE : To investigate closely the link between anxiety/depression and
COPD exacerbations resulting in hospitalization and readmissions.

METHODS : We conducted a cross-sectional study in a cohort of consenting
patients followed for confirmed COPD with a history of acute exacerbation of COPD
(AECOPD) at the pulmonology Department Pavilion IV in the pulmonology hospital
Abderrahman Mami, between January and December 2022. Disease severity was
assessed using spirometry, the improved ABCD assessment tool according to the
latest Global Initiative on Obstructive Lung Disease (GOLD) 2022
recommendations, and the modified Medical Research Council (mMRC) dyspnoea
scale. A telephone interview assessment of quality of life and personality traits was
conducted using Arabic versions of the CAT questionnaire and the Hospital Anxiety
and Depression scale (HAD) in order to assess anxiety and depression.

RESULTS : Our sample comprised 108 male patients. Of those, 59 (54.6%) were
readmitted at least twice during the 12-month follow-up period. Overall, anxiety
and depression was confirmed in 68 (62,96%) patients. The mean time for
readmission was 95 +-6,92 days.

Anxiety and depression was correlated with the occurrence of respiratory acidosis
during AECOPD (7,33 versus 7,44; p=0,01) with an extended length of stay (7,62
versus 5,32; p=0,002) and with a lower peripheral oxygen saturation at readmission
( 85,21% versus 89%; p=0,015). In multivariate analysis, anxiety and depression and
GOLD D category were independent risk predictors of readmission for AECOPD.
Remarkably, anxiety and depression scale improved the area under the receiver
operator curve [AUC=0,94 (0,88 - 0,99), P<10-3] with a sensitivity of 95% and a
specificity of 90%.

CONCLUSION : In summary, our data confirm the supposition that anxiety and
depression combined with GOLD category are independent predictors of

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