Objective: To investigate the major risk factors for acute exacerbations of chronic obstructive pulmonary disease (COPD) and the role of mental status in patients who survived the Wenchuan Earthquake.
Methods: A questionnaire survey was conducted in 301 COPD patients from the earthquake and non-earthquake areas in Sichuan one month, three months and 12 months after the Wenchuan Earthquake.
Results: A total of 269 patients with COPD completed this study, which included 133 patients earthquake area and 136 from non-earthquake area. (1) Patients from earthquake area had significant higher incidence of acute exacerbations of COPD than those from non-earthquake area 3 months (0.57 +/- 0.688 vs. 0.40 +/- 0.601) and 12 months (1.82 +/- 1.375 vs. 1.47 +/- 1.366) after the earthquake. (2) Patients from earthquake area had significant higher Modified British Medical Research Council (mMRC) grades of COPD than those from non-earthquake area 12 months (P < 0.05) after the earthquake. (3) Patients from earthquake area had significant higher prevalence of posttraumatic stress disorder (PTSD) and higher scores of Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) than those from non-earthquake area within one month and 3 months after the earthquake. The difference in PTSD prevalence remained significant 12 months after the earthquake. (4) No significant differences in the prevalence of PTSD and the scores of SAS and SDS were found within one month and 3 months after the earthquake, though significant improvements were observed 12 months after the earthquake for both participants from the earthquake and non-earthquake areas (P < 0.01). (5) Patients from earthquake area lived in worse environment than those from non-earthquake area during the first 3 months after the earthquake (P < 0.001). The living environments of both groups improved significantly 12 months later (P < 0.001). (6) Binary logistic regression showed that older age, worse pulmonary function, psychological disorder, worse living environment were risk factors of acute exacerbation of COPD after the Wenchuan Earthquake.
Conclusion: The earthquake caused serious psychological trauma in COPD patients. Older age, worse pulmonary function, psychological disorder, worse living environment are risk factors associated with acute exacerbation of COPD. COPD patients should receive psychotherapy and better living arrangement as early as possible after serious disasters.