Indian Journal of Respiratory Care

IJRC Email      Register      Login

VOLUME 8 , ISSUE 1 ( January-June, 2019 ) > List of Articles

Original Article

Prevalence of Dyspnea and its Associated Factors in Patients with Chronic Obstructive Pulmonary Disease

Sita Sharma, Pramod Sharma

Keywords : Anxiety, chronic obstructive pulmonary disease, depression, dyspnea, factors, prevalence

Citation Information : Sharma S, Sharma P. Prevalence of Dyspnea and its Associated Factors in Patients with Chronic Obstructive Pulmonary Disease. Indian J Respir Care 2019; 8 (1):36-41.

DOI: 10.4103/ijrc.ijrc_21_18

License: CC BY-NC-SA 4.0

Published Online: 05-12-2022

Copyright Statement:  Copyright © 2019; Indian Journal of Respiratory Care.


Background: Dyspnea is highly distressing experience of breathlessness that limits the activities of daily living and affects an increasingly large group of patients with respiratory diseases such as chronic obstructive pulmonary disease (COPD). Aims: The aim of our study was to investigate the prevalence of dyspnea and its associated factors in patients with COPD. Patients and Methods: This cross-sectional study was carried out among 221 COPD patients of Tribhuvan University Teaching Hospital, Nepal. Patients' dyspnea was assessed using the modified Medical Research Council Dyspnea Scale and Dyspnea 12 Questionnaire. Patient's anxiety and depression were measured using Hospital Anxiety and Depression Scale, and COPD Assessment Test (CAT) was used to measure the impact of COPD. Mann-Whitney and Kruskal-Wallis test were used to find out the association between variables. Multiple regression analysis was used to find out the most significant factor associated with dyspnea. Results: Out of 221 patients, almost all (92.8%) patients had some degrees of dyspnea. Dyspnea was statistically significantly associated with age (P < 0.001), education (P < 0.001), marital status (P < 0.001), type of family (P = 0.009), working status (P < 0.001), duration of illness (P < 0.001), history of previous hospitalization (P < 0.001), status of hospitalization in the last year (P < 0.001), domiciliary oxygen therapy (P < 0.001), other comorbidities (P < 0.001), anxiety (P < 0.001), and depression (P < 0.001). Conclusions: This study concludes that dyspnea is highly prevalent in COPD, and duration of illness, depression, and CAT score were the most significant factors associated with dyspnea in patients with COPD.

  1. Manning HL, Schwartzstein RM. Pathophysiology of dyspnea. N Engl J Med 1995;333:1547-53.
  2. Rabe KF, Hurd S, Anzueto A, Barnes PJ, Buist SA, Claverley P, et al. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med 2007;176:532-55.
  3. Parshall MB, Schwartzstein RM, Adams L, Banzett RB, Manning HL, Bourbeau J, et al. An official American thoracic society statement: Update on the mechanisms, assessment, and management of dyspnea. Am J Respir Crit Care Med 2012;185:435-52.
  4. Sharma P, Morris NR, Adams L. The effect of different exercise modalities on dyspnea and leg fatigue in healthy subjects. Respir Physiol Neurobiol 2015;210:44-50.
  5. von Leupoldt A, Dahme B. Experimental comparison of dyspnea and pain. Behav Res0020Methods 2007;39:137-43.
  6. Müllerová H, Lu C, Li H, Tabberer M. Prevalence and burden of breathlessness in patients with chronic obstructive pulmonary disease managed in primary care. PLoS One 2014;9:e85540.
  7. Sharma P, Morris NR, Adams L. Effect of experimental modulation of mood on perception of exertional dyspnea in healthy subjects. J Appl Physiol (1985) 2016;120:114-20.
  8. von Leupoldt A, Dahme B. Psychological aspects in the perception of dyspnea in obstructive pulmonary diseases. Respir Med 2007;101:411-22.
  9. Lu Y, Nyunt MS, Gwee X, Feng L, Feng L, Kua EH, et al. Life event stress and chronic obstructive pulmonary disease (COPD): Associations with mental well-being and quality of life in a population-based study. BMJ Open 2012;2:1-6.
  10. Roche N, Perez T, Neukirch F, Carré P, Terrioux P, Pouchain D, et al. High prevalence of COPD symptoms in the general population contrasting with low awareness of the disease. Rev Mal Respir 2011;28:e58-65.
  11. Bilgic Z, Tel H, Zorlu Z. Evaluation of Dyspnea and Fatigue Among the COPD Patients. Chronic Obstructive Pulmonary Disease - Current Concepts and Practice. Intechopen; 2010, 2020. p. 257-72.
  12. Punekar YS, Mullerova H, Small M, Holbrook T, Wood R, Naya I, et al. Prevalence and burden of dyspnoea among patients with chronic obstructive pulmonary disease in five European countries. Pulm Ther 2016;2:59-72.
  13. Barnes N, Calverley PM, Kaplan A, Rabe KF. Chronic obstructive pulmonary disease and exacerbations: Patient insights from the global hidden depths of COPD survey. BMC Pulm Med 2013;13:54.
  14. Haruna A, Oga T, Muro S, Ohara T, Sato S, Marumo S, et al. Relationship between peripheral airway function and patient-reported outcomes in COPD: A cross-sectional study. BMC Pulm Med 2010;10:10.
  15. Bestall JC, Paul EA, Garrod R, Garnham R, Jones PW, Wedzicha JA, et al. Usefulness of the medical research council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax 1999;54:581-6.
  16. Guenette JA, Jensen D, Webb KA, Ofir D, Raghavan N, O'Donnell DE, et al. Sex differences in exertional dyspnea in patients with mild COPD: Physiological mechanisms. Respir Physiol Neurobiol 2011;177:218-27.
  17. Koblizek V, Pracharova S, Papousek P. Gender difference in the perception of dyspnea in former smokers with COPD. Eur Respir J 2011;38 Suppl 55:3576.
  18. de Torres JP, Casanova C, Montejo de Garcini A, Aguirre-Jaime A, Celli BR. Gender and respiratory factors associated with dyspnea in chronic obstructive pulmonary disease. Respir Res 2007;8:18.
  19. Holm KE, Plaufcan MR, Ford DW, Sandhaus RA, Strand M, Strange C, et al. The impact of age on outcomes in chronic obstructive pulmonary disease differs by relationship status. J Behav Med 2014;37:654-63.
  20. Oga T, Tsukino M, Hajiro T, Ikeda A, Nishimura K. Analysis of longitudinal changes in dyspnea of patients with chronic obstructive pulmonary disease: An observational study. Respir Res 2012;13:85.
  21. Gianjoppe-Santos J, Sentanin AC, Barusso MS, Rizzatti FP, Jamami M, Pires Di Lorenzo VA. Impact of exacerbation of COPD on anxiety and depression symptoms and dyspnea in the activities of daily living. Eur Respir J 2015;46 Suppl 59. Available from http://link.lis.curtin. [Last retrieved on 2017 Feb 11].
  22. Borges-Santos E, Wada JT, da Silva CM, Silva RA, Stelmach R, Carvalho CR, et al. Anxiety and depression are related to dyspnea and clinical control but not with thoracoabdominal mechanics in patients with COPD. Respir Physiol Neurobiol 2015;210:1-6.
  23. Kim S, Oh J, Kim YI, Ban HJ, Kwon YS, Oh IJ, et al. Differences in classification of COPD group using COPD assessment test (CAT) or modified medical research council (mMRC) dyspnea scores: A cross-sectional analyses. BMC Pulm Med 2013;13:35.
  24. Huang WC, Wu MF, Chen HC, Hsu JY, TOLD Group. Features of COPD patients by comparing CAT with mMRC: A retrospective, cross-sectional study. NPJ Prim Care Respir Med 2015;25:15063.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.