A new study finds that health-related quality of life does not affect end-of-life treatment preferences in patients with chronic obstructive pulmonary disease (COPD); yet, depression may influence treatment decisions in the same group of patients. In a study of 101 patients (median age 67.4 years) with severe COPD, researchers from the University of Seattle, Seattle, WA, compared depression and health-related quality of life scores with patient preferences for cardiopulmonary resuscitation (CPR) and mechanical ventilation. The majority of patients reported they would want CPR and mechanical ventilation, but, as age increased, so did the likelihood that patients would refuse both treatments. Further analysis revealed that health-related quality of life was not associated with end-of-life treatment preferences, but that a higher burden of depressive symptoms was significantly associated with a preference against CPR, although it was not associated with preference for mechanical ventilation. Researchers conclude that clinicians should recognize the influence depression may have on patient treatment preferences and that improvement in depression symptoms may warrant reassessment of patient treatment preferences. The study appears in the January issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.

SLEEP-DISORDERED BREATHING A RISK FACTOR FOR CARDIOVASCULAR MORBIDITY

According to a recent study, sleep-disordered breathing (SDB) may be a possible risk factor for cardiovascular morbidity, but researchers also found a diagnosis of SDB may be inaccurate in unstable patients. In a study of 26 patients presenting with unstable angina, myocardial infarction, or left ventricular failure, researchers from the University of Otago, Dunedin, New Zealand, found 13 patients (50%) had SDB. In a follow-up study of 18 of
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Contact: Jennifer Stawarz
jstawarz@chestnet.org
847-498-8306
American College of Chest Physicians
10-Jan-2005