The prognosis of pre-frail chronic obstructive pulmonary disease patients for hospitalizations and mortality depends on their level of functional physical performance

Abstract

Objective To determine if pre-frail Chronic obstructive pulmonary disease (COPD) patients with poor and non-poor performance in the five-repetition sit-to-stand test (5-STS) had a worse prognosis for hospitalization and mortality at 2 years and for mortality at 5 years than non-frail patients. Methods We prospectively included patients with stable COPD, between 40 and 80 years, from a hospital in Spain. Patients were classified according their performance on the 5-STS test and level of frailty. Timing, number of hospitalizations, length of stay, and timing and rate of mortality were outcome measures. Patients were followed for 2 years for exacerbations and for 5 years for mortality. Kaplan-Meier curves and univariate and multivariate Cox proportional-hazard analyses, ANOVA tests and univariate and multivariate linear and logistic regression models were used. Results Of the 125 patients included, 25.6% were pre-frail with poor performance, 57% pre-frail with non-poor performance, and 17.4% non-frail with non-poor performance. Pre-frail patients with poor performance had a higher number of hospitalizations (adjusted beta: 0.49; 95% CI: 0.01–0.96), mortality rates (odds ratio: 11.33; 95% CI: 1.15–110.81), and risk at 5 years (adjusted hazard ratio: 8.77; 95% CI: 1.02–75.51) than non-frail patients. Pre-frail patients with poor performance also had worse prognoses than non-frail patients with respect to length of hospital stays (increased by 4.16 days) and timing to first hospitalization (HR: 6.01) in unadjusted models, but not when adjusted. Conclusion The COPD prognosis of pre-frail patients with respect to the number of exacerbations with hospitalization and the timing and rate of mortality is dependent of functional performance.

Chronic Obstructive Pulmonary Disease and Gait Disturbance: Is There Any Meaningful Link? Unveiling the Interplay and Addressing the Challenges

“…The studies reported a fall rate of up to 50% in this population. The presence of balance deficits and gait disturbances has been identified as a significant risk factor for falls in COPD patients [59][60][61][62]. Furthermore, the long-term alteration of posture (breathing at a high lung volume [hyperinflated lungs], which causes a slight backward displacement of the thorax and high shoulder position), muscle dysfunction, and the use of steroids, may lead to breathing and gait disturbances [12,63].…”

“…The integration of social robots in rehabilitation can have benefits and distinct advantages. One advantage is one-on-one support; social robots provide personalized support, enabling healthcare professionals to dedicate more time and attention to individual patient needs [59]. Also, robots can be utilized as a tool for gait assessment, complementing traditional methods and providing valuable data for healthcare professionals to analyze and tailor treatment plans accordingly [63].…”