{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T20:05:34Z","timestamp":1775851534849,"version":"3.50.1"},"reference-count":44,"publisher":"Elsevier BV","issue":"12","license":[{"start":{"date-parts":[[2012,12,1]],"date-time":"2012-12-01T00:00:00Z","timestamp":1354320000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2012,12,1]],"date-time":"2012-12-01T00:00:00Z","timestamp":1354320000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2014,12,1]],"date-time":"2014-12-01T00:00:00Z","timestamp":1417392000000},"content-version":"vor","delay-in-days":730,"URL":"http:\/\/www.elsevier.com\/open-access\/userlicense\/1.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","resmedjournal.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Respiratory Medicine"],"published-print":{"date-parts":[[2012,12]]},"DOI":"10.1016\/j.rmed.2012.09.009","type":"journal-article","created":{"date-parts":[[2012,10,8]],"date-time":"2012-10-08T20:30:21Z","timestamp":1349728221000},"page":"1734-1742","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":33,"title":["Factors associated with high healthcare resource utilisation among COPD patients"],"prefix":"10.1016","volume":"106","author":[{"given":"Cayo","family":"Garc\u00eda-Polo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernardino","family":"Alc\u00e1zar-Navarrete","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis Alberto","family":"Ruiz-Iturriaga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Herrej\u00f3n","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Antonio","family":"Ros-Lucas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia","family":"Garc\u00eda-Sidro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gema","family":"Tirado-Conde","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Luis","family":"L\u00f3pez-Campos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Mart\u00ednez-Rivera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joaquin","family":"Cost\u00e1n-Galicia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sagrario","family":"Mayoralas-Alises","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier","family":"De Miguel-D\u00edez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc","family":"Miravitlles","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"key":"10.1016\/j.rmed.2012.09.009_bib1","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1016\/S0140-6736(11)60968-9","article-title":"Chronic obstructive pulmonary disease","volume":"379","author":"Decramer","year":"2012","journal-title":"Lancet"},{"key":"10.1016\/j.rmed.2012.09.009_bib2","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1136\/thx.2009.115725","article-title":"Prevalence of COPD in Spain: impact of undiagnosed COPD on quality of life and daily life activities","volume":"64","author":"Miravitlles","year":"2009","journal-title":"Thorax"},{"key":"10.1016\/j.rmed.2012.09.009_bib3","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1378\/chest.123.3.784","article-title":"Costs of chronic bronchitis and COPD. A one year follow-up study","volume":"123","author":"Miravitlles","year":"2003","journal-title":"Chest"},{"key":"10.1016\/j.rmed.2012.09.009_bib4","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1056\/NEJMoa021322","article-title":"The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease","volume":"350","author":"Celli","year":"2004","journal-title":"N Engl J Med"},{"key":"10.1016\/j.rmed.2012.09.009_bib5","first-page":"375","article-title":"Quality of life in patients with chronic obstructive pulmonary disease","volume":"38","author":"Jones","year":"2006","journal-title":"Eur Respir Mon"},{"key":"10.1016\/j.rmed.2012.09.009_bib6","first-page":"224","article-title":"Systemic effects of chronic obstructive pulmonary disease","volume":"38","author":"Wouters","year":"2006","journal-title":"Eur Respir Mon"},{"key":"10.1016\/j.rmed.2012.09.009_bib7","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1177\/1753465811400490","article-title":"COPD: a multifactorial systemic disease","volume":"5","author":"Huertas","year":"2011","journal-title":"Ther Adv Respir Dis"},{"key":"10.1016\/j.rmed.2012.09.009_bib8","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1183\/09031936.05.00078504","article-title":"Risk factors for rehospitalisation in COPD: role of health status, anxiety and depression","volume":"26","author":"Gudmundsson","year":"2005","journal-title":"Eur Respir J"},{"key":"10.1016\/j.rmed.2012.09.009_bib9","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1159\/000328766","article-title":"Socioeconomic status and health-related quality of life of patients with COPD","volume":"82","author":"Miravitlles","year":"2011","journal-title":"Respiration"},{"key":"10.1016\/j.rmed.2012.09.009_bib10","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1016\/j.rmed.2004.02.013","article-title":"Resource use and risk factors in high-cost exacerbations of COPD","volume":"98","author":"Oostenbrink","year":"2004","journal-title":"Respir Med"},{"key":"10.1016\/j.rmed.2012.09.009_bib11","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/j.rmed.2003.04.001","article-title":"Risk factors of emergency care and admissions in COPD patients with high consumption of health resources","volume":"98","author":"Soler","year":"2004","journal-title":"Respir Med"},{"key":"10.1016\/j.rmed.2012.09.009_bib12","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1007\/s11136-005-3215-y","article-title":"Exacerbations, hospital admissions and impaired health status in chronic obstructive pulmonary disease","volume":"15","author":"Miravitlles","year":"2006","journal-title":"Qual Life Res"},{"key":"10.1016\/j.rmed.2012.09.009_bib13","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.arbres.2011.10.009","article-title":"Factors associated with hospital admission for exacerbation of chronic obstructive lung disease","volume":"48","author":"Alc\u00e1zar","year":"2012","journal-title":"Arch Bronconeumol"},{"key":"10.1016\/j.rmed.2012.09.009_bib14","series-title":"Manual de procedimientos SEPAR. Procedimientos de evaluaci\u00f3n de la funci\u00f3n pulmonar -II-. Mallorca","first-page":"100","article-title":"Prueba de marcha de 6 minutos","author":"Vilaro","year":"2004"},{"key":"10.1016\/j.rmed.2012.09.009_bib15","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: development and validation","volume":"40","author":"Charlson","year":"1987","journal-title":"J Chronic Dis"},{"key":"10.1016\/j.rmed.2012.09.009_bib16","first-page":"79","article-title":"La versi\u00f3n espa\u00f1ola del EuroQoL: descripci\u00f3n y aplicaciones","volume":"112","author":"Badia","year":"1999","journal-title":"Med Clin"},{"key":"10.1016\/j.rmed.2012.09.009_bib17","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1136\/thx.54.7.581","article-title":"Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease","volume":"54","author":"Bestall","year":"1999","journal-title":"Thorax"},{"key":"10.1016\/j.rmed.2012.09.009_bib18","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1053\/rmed.2000.0786","article-title":"Development and validation of a standardized measure of activity of daily living in patients with severe COPD: the London Chest Activity of Daily Living scale (LCADL)","volume":"94","author":"Garrod","year":"2000","journal-title":"Respir Med"},{"key":"10.1016\/j.rmed.2012.09.009_bib19","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1157\/13109543","article-title":"Actividades de la vida diaria en pacientes con enfermedad pulmonar obstructiva cr\u00f3nica: validaci\u00f3n de la traducci\u00f3n espa\u00f1ola y an\u00e1lisis comparativo de 2 cuestionarios","volume":"29","author":"Vilar\u00f3","year":"2007","journal-title":"Med Clin"},{"key":"10.1016\/j.rmed.2012.09.009_bib20","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/S0163-8343(03)00043-4","article-title":"A validation study of the hospital anxiety and depression scale (HADS) in a Spanish population","volume":"25","author":"Herrero","year":"2003","journal-title":"Gen Hosp Psychiatry"},{"key":"10.1016\/j.rmed.2012.09.009_bib21","doi-asserted-by":"crossref","first-page":"306","DOI":"10.3109\/15412555.2011.578601","article-title":"Daily physical activity in patients with chronic obstructive pulmonary disease: a systematic review","volume":"8","author":"Bossenbroek","year":"2011","journal-title":"COPD"},{"key":"10.1016\/j.rmed.2012.09.009_bib22","doi-asserted-by":"crossref","first-page":"1611","DOI":"10.1016\/j.apmr.2011.05.012","article-title":"Evidence of an early physical activity reduction in chronic obstructive pulmonary disease patients","volume":"92","author":"Gouzi","year":"2011","journal-title":"Arch Phys Med Rehabil"},{"key":"10.1016\/j.rmed.2012.09.009_bib23","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1183\/09031936.00021409","article-title":"Impact of changes in physical activity on health-related quality of life among patients with COPD","volume":"36","author":"Esteban","year":"2010","journal-title":"Eur Respir J"},{"key":"10.1016\/j.rmed.2012.09.009_bib24","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.arbres.2011.03.004","article-title":"Physical activity and its relationship with the state of health of stable COPD patients","volume":"47","author":"Mar\u00edn Royo","year":"2011","journal-title":"Arch Bronconeumol"},{"key":"10.1016\/j.rmed.2012.09.009_bib25","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1136\/thx.2006.060145","article-title":"Regular physical activity reduces hospital admission and mortality in chronic obstructive pulmonary disease: a population based cohort study","volume":"61","author":"Garcia-Aymerich","year":"2006","journal-title":"Thorax"},{"key":"10.1016\/j.rmed.2012.09.009_bib26","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1378\/chest.10-2521","article-title":"Physical activity is the strongest predictor of all-cause mortality in patients with COPD: a prospective cohort study","volume":"140","author":"Waschki","year":"2011","journal-title":"Chest"},{"key":"10.1016\/j.rmed.2012.09.009_bib27","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1016\/j.arbr.2011.07.004","article-title":"Validation of the Yale Physical Activity Survey in chronic obstructive pulmonary disease patients","volume":"47","author":"Donaire-Gonz\u00e1lez","year":"2011","journal-title":"Arch Bronconeumol"},{"key":"10.1016\/j.rmed.2012.09.009_bib28","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1164\/rccm.200408-1054OC","article-title":"Exacerbations and time spent outdoors in chronic obstructive pulmonary disease","volume":"171","author":"Donaldson","year":"2005","journal-title":"Am J Respir Crit Care Med"},{"key":"10.1016\/j.rmed.2012.09.009_bib29","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1016\/j.rmed.2009.02.002","article-title":"Impact of hospitalizations for exacerbations of COPD on health-related quality of life","volume":"103","author":"Esteban","year":"2009","journal-title":"Respir Med"},{"key":"10.1016\/j.rmed.2012.09.009_bib30","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1136\/thx.2003.008730","article-title":"Exacerbations impair quality of life in patients with chronic obstructive pulmonary disease. A two-year follow-up study","volume":"59","author":"Miravitlles","year":"2004","journal-title":"Thorax"},{"key":"10.1016\/j.rmed.2012.09.009_bib31","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1164\/rccm.201003-0472OC","article-title":"Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study investigators. Determinants of depression in the ECLIPSE chronic obstructive pulmonary disease cohort","volume":"183","author":"Hanania","year":"2011","journal-title":"Am J Respir Crit Care Med"},{"key":"10.1016\/j.rmed.2012.09.009_bib32","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1164\/rccm.200804-619OC","article-title":"Independent effect of depression and anxiety on chronic obstructive pulmonary disease exacerbations and hospitalizations","volume":"178","author":"Xu","year":"2008","journal-title":"Am J Respir Crit Care Med"},{"key":"10.1016\/j.rmed.2012.09.009_bib33","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1378\/chest.08-0078","article-title":"Depressive symptoms as predictors of mortality in patients with COPD","volume":"135","author":"de Voogd","year":"2009","journal-title":"Chest"},{"key":"10.1016\/j.rmed.2012.09.009_bib34","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1097\/MCP.0b013e3283218318","article-title":"Does pulmonary rehabilitation reduce anxiety and depression in chronic obstructive pulmonary disease?","volume":"15","author":"Coventry","year":"2009","journal-title":"Curr Opin Pulm Med"},{"key":"10.1016\/j.rmed.2012.09.009_bib35","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1097\/PHM.0b013e31802b8eca","article-title":"Pulmonary rehabilitation improves depression, anxiety, dyspnea and health status in patients with COPD","volume":"86","author":"Paz-D\u00edaz","year":"2007","journal-title":"Am J Phys Med Rehabil"},{"key":"10.1016\/j.rmed.2012.09.009_bib36","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1177\/1753465810382818","article-title":"The impact of psychological distress on exacerbation rates in COPD","volume":"5","author":"Laurin","year":"2011","journal-title":"Ther Adv Respir Dis"},{"key":"10.1016\/j.rmed.2012.09.009_bib37","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1136\/thx.2009.126201","article-title":"Influence of anxiety on health outcomes in COPD","volume":"65","author":"Eisner","year":"2010","journal-title":"Thorax"},{"key":"10.1016\/j.rmed.2012.09.009_bib38","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1186\/1465-9921-12-146","article-title":"the Evaluation of COPD Longitudinally to Identify Surrogate Endpoints (ECLIPSE) study investigators. COPD association and repeatability of blood biomarkers in the ECLIPSE cohort","volume":"12","author":"Dickens","year":"2011","journal-title":"Respir Res"},{"key":"10.1016\/j.rmed.2012.09.009_bib39","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1056\/NEJMoa0909883","article-title":"Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) Investigators. Susceptibility to exacerbation in chronic obstructive pulmonary disease","volume":"363","author":"Hurst","year":"2010","journal-title":"N Engl J Med"},{"key":"10.1016\/j.rmed.2012.09.009_bib40","first-page":"173","article-title":"Fibrinogen, chronic obstructive pulmonary disease (COPD) and outcomes in two United States cohorts","volume":"7","author":"Valvi","year":"2012","journal-title":"Int J Chron Obst Pulm Dis"},{"key":"10.1016\/j.rmed.2012.09.009_bib41","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1378\/chest.09-2764","article-title":"The effects of hypoxia on markers of coagulation and systemic inflammation in patients with COPD","volume":"138","author":"Sabit","year":"2010","journal-title":"Chest"},{"key":"10.1016\/j.rmed.2012.09.009_bib42","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1378\/chest.08-2532","article-title":"Physical activity and clinical and functional status in COPD","volume":"136","author":"Garcia-Aymerich","year":"2009","journal-title":"Chest"},{"key":"10.1016\/j.rmed.2012.09.009_bib43","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1111\/j.1752-699X.2010.00208.x","article-title":"Relation between physical capacity, nutritional status and systemic inflammation in COPD","volume":"5","author":"Hallin","year":"2011","journal-title":"Clin Respir J"},{"key":"10.1016\/j.rmed.2012.09.009_bib44","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1136\/thx.2010.155333","article-title":"Biochemical markers of cardiac dysfunction predict mortality in acute exacerbations of COPD","volume":"66","author":"Chang","year":"2011","journal-title":"Thorax"}],"container-title":["Respiratory Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0954611112003502?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0954611112003502?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T11:20:28Z","timestamp":1760613628000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0954611112003502"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,12]]},"references-count":44,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2012,12]]}},"alternative-id":["S0954611112003502"],"URL":"https:\/\/doi.org\/10.1016\/j.rmed.2012.09.009","relation":{},"ISSN":["0954-6111"],"issn-type":[{"value":"0954-6111","type":"print"}],"subject":[],"published":{"date-parts":[[2012,12]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Factors associated with high healthcare resource utilisation among COPD patients","name":"articletitle","label":"Article Title"},{"value":"Respiratory Medicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.rmed.2012.09.009","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"Copyright \u00a9 2012 Elsevier Ltd. All rights reserved.","name":"copyright","label":"Copyright"}]}}