Estimating the effectiveness of pulmonary rehabilitation for COPD exacerbations: reduction of hospital inpatient days during the following year

Katajisto, Milla; Laitinen, Tarja

doi:10.2147/copd.s144571

Cited by 21 publications

(17 citation statements)

References 24 publications

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“…As such, the two treatment modalities may be beneficial to different subgroups of patients or indications may change with disease progression. Katajisto et al recently showed rehabilitation to be preventive of hospitalization in patients with advanced COPD [21]. As for exacerbations, future studies will have to investigate the place of the different preventive strategies in COPD patients in need of LTOT.…”

Section: Discussionmentioning

confidence: 99%

Domiciliary high-flow treatment in patients with COPD and chronic hypoxic failure: In whom can we reduce exacerbations and hospitalizations?

Weinreich

2019

PLoS ONE

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IntroductionDomiciliary High-flow, humidified, nasal cannula (HFNC) is a possible add-on in patients with chronic respiratory diseases. This post-hoc study investigates benefit of HFNC in subgroups of advanced COPD patients with chronic hypoxic failure on reduction of exacerbations and hospitalizations.MethodsOne hundred patients were randomized to HFNC in a previous trial. Subgroups with 0–1 (N = 32) respectively two or more (2+) (N = 68) exacerbations 12 months pre-study were investigated. Changes in number of exacerbations and hospitalizations pre- and in study were analyzed, corrected for HFNC days with HFNC.ResultsPatients were comparable at baseline. Exacerbations increased in subgroup 0–1 (p = 0.01) and decreased in subgroup 2+ (p = 0.03). Correcting for HFNC days no correlation was seen in subgroup 0–1 (p = 0.08), but in subgroup 2+ (p<0.001). Number of hospitalizations increased in subgroup 0–1 (p = 0.01) with no change in days of hospitalization (p = 0.08). Number and days of hospitalization decreased in subgroup 2+ (p = 0.002 resp. 0.025). Correcting for HFNC days no correlation was found in number or days of hospitalization in subgroup 0–1 (p = 0.48 and p = 0.65). Positive correlation was found in subgroup 2+ (both p<0.001).ConclusionIn patients with advanced COPD, chronic hypoxic failure and two or more exacerbations per year, HFNC significantly reduced exacerbations and hospitalizations.

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Section: Discussionmentioning

confidence: 99%

Domiciliary high-flow treatment in patients with COPD and chronic hypoxic failure: In whom can we reduce exacerbations and hospitalizations?

Weinreich

2019

PLoS ONE

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“…All studies found that pulmonary rehabilitation programs or individual physical therapy programs were effective in improving the quality of life [12][13][14][15][16][17], physical endurance [12][13][14][15][16][18][19][20][21][22][23], respiratory muscle strength [13,18,23], reducing symptoms of CoPd [14,16,19,23], improving the function of external breathing [16,[24][25][26], blood parameters [22,27], cognitive functions [21], functional state of muscles [28], survival rates [29,30], and reducing the number of hospital days [31]. The main part of investigations was devoted to the comparison of therapeutic rehabilitation programs that included several components and referred to stable patients with CoPd.…”

Section: Resultsmentioning

confidence: 99%

“…The main part of investigations was devoted to the comparison of therapeutic rehabilitation programs that included several components and referred to stable patients with CoPd. only a few studies considered the effects of individual interventions of the physical therapy arsenal [20-22, 24, 27] and the effectiveness of pulmonary rehabilitation in a hospital environment at CoPd exacerbation [17,19,31,32] ( Table 2). …”

Section: Resultsmentioning

confidence: 99%

Physical therapy in chronic obstructive pulmonary disease (analysis of the evidence-based medicine)

Tymruk-Skoropad¹,

Tsizh²,

Vynogradskyi³

et al. 2018

Physiother Quart.

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Introduction. The purpose of the study is to present the forms of rehabilitation used in chronic obstructive pulmonary disease (CoPd) in various centres. Widespread occurrence of CoPd, significant disability, high treatment costs, permanently increasing and more profound knowledge about the pathogenesis and course of CoPd lead to a comprehensive study of respiratory rehabilitation and physical therapy of the disease. Conclusions. in evidence-based medicine databases, in the total number of the published research results pertaining to CoPd, the proportion of studies on rehabilitation makes up 9.8-15.95%, and that of physical therapy constitutes 3.8-11.5%. Taking into consideration the conclusions of systematic reviews with reference to the key role of rehabilitation and physical therapy in the CoPd patients' treatment, close attention should be focused currently on the identification of indispensable components of respiratory rehabilitation and the evaluation of its efficacy.

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“…Schuler et al [13] on 383 COPD patients noted a decreased number of exacerbations (moderate and severe) one year after PR. Katajisto and Laitinen [14] showed the decreasing of hospitalization due to exacerbation after PR, but the study was limited by small number of patients. Seymour et al [15] analyzed 60 patients, the proportion of patients that experienced an exacerbation in previous period resulting in an unplanned hospital attendance was 57% in the non-PR group and 27% in those receiving PR.…”

Section: Discussionmentioning

confidence: 99%

The influence of pulmonary rehabilitation on the exacerbations of chronic obstructive pulmonary disease in Serbia

et al. 2020

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Introduction/Objective The chronic obstructive pulmonary disease (COPD) exacerbations have a major impact on outcomes of COPD patients. Pulmonary rehabilitation (PR) interrupts the vicious circle caused by exacerbations. It has not been widely implemented as standard of COPD treatment yet. The aim of study was to examine the effectiveness of PR in prevention of exacerbations. Method The prospective observation study included stable COPD patients between January 2015 and December 2018. The effects of PR on exacerbation rates were evaluated using univariate and multivariate logistic regression analysis, taking into account age, comorbidity, vaccination status (against seasonal flu), body mass index (BMI).Results Study included 1,674 patients (956 males, age 65.93 ± 8.45, current or ex-smokers 94.9%; 21 ≥ BMI 1,406 patients, 84%, FEV 1 < 80% 1,448 patients, 86.5%). The PR rate was 48.1%. There was significant difference in PR status with respect to age (p = 0.020), comorbidities (p = 0.015), FEV 1 (p < 0.001), respiratory symptoms using COPD assessment test (CAT) score (p < 0.001), vaccination against seasonal flu (p < 0.001). Exacerbations occurred more frequently in non-PR patients (415 (51.6%) vs. 641 (73.7%), p < 0.001). In multivariate analysis, PR (RR 0.421; 95% CI (0.307-0.577); p < 0.001) and BMI ≥ 21kg/m 2 (RR 0.605; 95% CI (0.380-0.965); p = 0.035) were independent protective factors and CAT score >10 (RR 2.375; 95% CI (1.720-3.280); p < 0.001) and FEV 1 < 80% (RR 2.021; 95% CI (1.303-3.134); p = 0.002) were independent risk factors from exacerbations. Conclusion Patients who successfully completed PR treatment had significantly less frequent exacerbations compared to patients that not pass through PR program.

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Estimating the effectiveness of pulmonary rehabilitation for COPD exacerbations: reduction of hospital inpatient days during the following year

Cited by 21 publications

References 24 publications

Domiciliary high-flow treatment in patients with COPD and chronic hypoxic failure: In whom can we reduce exacerbations and hospitalizations?

Domiciliary high-flow treatment in patients with COPD and chronic hypoxic failure: In whom can we reduce exacerbations and hospitalizations?

Physical therapy in chronic obstructive pulmonary disease (analysis of the evidence-based medicine)

The influence of pulmonary rehabilitation on the exacerbations of chronic obstructive pulmonary disease in Serbia

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