Physical Activity, Health Status and Risk of Hospitalization in Patients with Severe Chronic Obstructive Pulmonary Disease

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of death and 70% of the cost of COPD is due to hospitalizations. Self-reported daily physical activity and health status have been reported as predictors of a hospitalization in COPD but are not routinely assessed. Objectives: We tested the hypothesis that self-reported daily physical activity and health status assessed by a simple question were predictors of a hospitalization in a well-characterized cohort of patients with severe emphysema. Methods: Investigators gathered daily physical activity and health status data assessed by a simple question in 597 patients with severe emphysema and tested the association of those patient-reported outcomes to the occurrence of a hospitalization in the following year. Multiple logistic regression analyses were used to determine predictors of hospitalization during the first 12 months after randomization. Results: The two variables tested in the hypothesis were significant predictors of a hospitalization after adjusting for all univariable significant predictors: >2 h of physical activity per week had a protective effect [odds ratio (OR) 0.60; 95% confidence interval (95% CI) 0.41–0.88] and self-reported health status as fair or poor had a deleterious effect (OR 1.57; 95% CI 1.10–2.23). In addition, two other variables became significant in the multivariate model: total lung capacity (every 10% increase) had a protective effect (OR 0.88; 95% CI 0.78–0.99) and self-reported anxiety had a deleterious effect (OR 1.75; 95% CI 1.13–2.70). Conclusion: Self-reported daily physical activity and health status are independently associated with COPD hospitalizations. Our findings, assessed by simple questions, suggest the value of patient-reported outcomes in developing risk assessment tools that are easy to use.

Benefits of physical activity on COPD hospitalisation depend on intensity

“…The extensive clinical, physiological and biological characterisation of participants within the framework of the PAC-COPD study [10] allowed the inclusion of potential confounders in the analysis, including history of previous COPD hospitalisations, which was not considered in previous studies [15,16,36]. Likewise, the use of an objective method to quantify physical activity (and the high compliance level) contrasts with previous studies that mainly used self-reported questionnaires [14,15,36,37], reduces misclassification and allows the dissection of the role of different physical activity characteristics. In theory, our results could be explained by reverse causation, i.e.…”

Evaluation of physical activity in patients with chronic obstructive pulmonary disease: recommendations of European Respiratory Society

“…На сегодняшний день взаимосвязь между уровнем регулярной ФА и частотой госпитализаций при обострениях ХОБЛ изучалось в 7 проспективных продольных исследованиях [30,113,[141][142][143][144][145] и во всех показана стабильная достоверная взаимосвязь низкой ФА с повышением риска госпитализаций. Несмотря на то, что результаты скорректированы по сопутствующим факторам, только в 1 исследовании корректировка производилась еще и по частоте предшествующих направлений в стационар по пово ду ХОБЛ, которые являются важнейшим фактором повторных госпитализаций [146].…”

“…Несмотря на то, что результаты скорректированы по сопутствующим факторам, только в 1 исследовании корректировка производилась еще и по частоте предшествующих направлений в стационар по пово ду ХОБЛ, которые являются важнейшим фактором повторных госпитализаций [146]. Продемонстриро вано, что объем регулярной ФА, необходимый для получения доказательств достоверного влияния на частоту госпитализаций у пациентов с ХОБЛ, доста точно невелик и эквивалентен ходьбе пешком или езде на велосипеде в течение 2 ч в неделю [30,113,[141][142][143][144][145].…”

The relationship between physical function and experience of fatigue in patients with chronic obstructive pulmonary disease

“…In patients with COPD, the level of physical activity is found to be a predictor of hospital admission and mortality [44][45][46][47] . Maintaining low PA or a decrease in PA in a five year follow-up study was associated with a significant decline in health-related quality of life (HRQL) while an increase in HRQL was found in those who maintained a high level of PA 48 .…”