The Correlation Analysis Study Of Dyspnea Visual Analogue Scale With AECOPD Hormone Use

Objective The comparative study included the varying of dyspnea assessment index, the duration of hormone therapy and outcome of Biochemical examination to analyze the use of dyspnea VAS in the management of patients with AECOPD, and to explore the value of the preliminary VAS assessment in guiding hormone use of AECOPD.Methods 69 inpatients( males=55,females=14)diagnosed acute exacerbation of COPD in the the first affiliated hospital of Anhui medical university Department of Respiratory Medicine from December 2013 to May2014 were studied. Patients in our hospital or the outer court did pulmonary function test, satisfying the standard of diagnosis of chronic obstructive pulmonary disease, all patients were discharged from hospital after treatment to improve. Ruled out the patients who had systemic application of hormone during this period of acute exacerbation or other system diseases that can cause breathing difficulties, including the circulation, blood, nerves, digestive system disease, asthma and pneumonia, pulmonary embolism, lung cancer and other diseases.All patients completed the Visual Analog scale(VAS),Modified Borg’s score(MBS), and modified Medical Research Council 24 hours before admission and discharge. Collected the patients’ general information including age, gender, height, weight, complications, etc. Concentration of Blood routine test,Serum C-reactive protein(CRP),blood gas analysis,duration of hospital stay and time exposed to glucocorticoid therapy were Assayed at the same time.Correlations between the VAS,MBS and hormoneherapy were examined.Results 1. The trial included in a total of 69 cases: males 55 cases, female 14 cases, aged from 51 to 91 years old, Patients admitted to hospital CRP: log10 CRP 1.06 ±0.57 mg/L, the WBC 7.98 ± 3.55(10 ^ 9 / L), the percent of neutrophile granulocyte 73.10±13.11,Pa O2 67.77 ±12.95(mm Hg) Pa CO2 48.6±16.42(mm Hg), m MRC score 3.43±0.65, Borg score 5.73±1.86, VAS score 6.22± 1.87, all of the patients, on average, hormone use number 5.71± 3.75 days; There was no difference between the two groups(hormone needed group as group 2, the other as group 1) of in respect of age, sex, BMI,smoking history, complications, the WBC count, CRP and hospitalization days. Oxygen partial pressure of group 2 was lower than that in group 1, co2 partial pressure and the percent of neutrophile granulocyte were significantly higher than those. 2. VAS score at admission are not correlation(p > 0.05) with CRP and the total number of white blood cells,negatively related with Pa O2, and were positively correlated with Pa CO2 partial pressure、the percent of neutrophile granulocyte and hormone use time. Visual Analog questionnaire kept good consistency with Borg score good(r = 0.936, p < 0.01), a moderate correlation with m MRC score(r = 0.544, p < 0.01).There was a weak correlation between the m MRC and hormone use time(r = 0.308, P < 0.05).Borg score(r = 0.735, P < 0.735) and VAS score(r = 0.751, P < 0.01) were significantly correlated to the hormone use time. 3. Using these data, we performed a regression analysis to examine the application of VAS in the managent of glucocorticoids duration,the regression coefficient b=1.505,p<0.01.VAS score can be divided into three levels; 0 ~ 3 mild, 4 ~ 6 medium, 7 ~ 10 severe. mild dyspnea seven people, including 0 use hormone(0%);Moderate difficulty breathing 32 people, including 25 people using hormone(78%);Severe dyspnea 30 people, using hormones 30(100%);With dyspnea score increasing, the proportion of the patients with hormone was gradually risng.4. VAS scores of hospitalized patients had apparent decline(d = 3.939 ±1.459, P < 0.01) after treatment.,and d value was positively correlated with glucocorticoid use time(r = 0.842, P < 0.05).Conclusion For the patients of AECOPD, the VAS at admission can exactly assess the patients’ dyspnea, as potential useful instruments to assess the usage of glucocorticoid following COPD exacerbation and to evaluate the efficacy of treatment.