S32 The Relationship Between Exercise Capacity And Inflammatory Markers At Copd Exacerbation

Abstract

Conclusions Age, admission NEWS and blood parameters differed significantly between those who were managed on the ward with AECOPD and those who either died or whose care was escalated to ICU. This could form the basis for a prediction score, automatically calculable on admission to hospital using available technology to highlight those patients judged at greatest risk of deterioration. Introduction Chronic obstructive pulmonary disease (COPD) is characterised by breathlessness, fatigue and reduced daily activity which worsens acutely at exacerbation. A three year observational study has shown a reduction in 6MWT over time that correlates with increase over the same period in plasma Interleukin-6 and C-reactive protein (CRP) levels (Ferrari, Tanni et al. 2013). We therefore investigated whether acute changes in 6MWT at exacerbation were associated with changes in systemic inflammatory markers and the perception of fatigue. Methods Forty four patients from the London COPD cohort who had a mean age of (±SD) 71(±7) years; FEV 1 52(±17)% predicted; male gender 72% and still smoking 30% were asked to performed a 6MWT and completed a FACIT-F questionnaire when stable (baseline) and 3 days after first presenting with the exacerbation. Blood was drawn for assay of CRP and fibrinogen. REFERENCE

Physical activity and exercise capacity in patients with moderate COPD exacerbations

“…We therefore prospectively investigated whether acute changes in physical activity during naturally acquired, outpatient-treated exacerbations were associated with changes in exercise capacity, quadriceps strength, systemic inflammatory markers and fatigue levels. Some of the findings of this study have been previously reported in abstract form [13,14].…”

“…Various contributors to muscle weakness at exacerbation have been hypothesised, including immobility, treatment with corticosteroids, nutritional deficit, oxidative stress and inflammation [11]. There have been studies of exercise capacity, physical activity and muscle strength during the very early phases of hospitalised exacerbations [8,9], but few studies have examined moderate exacerbations treated in the community [12][13][14].…”