Survival following pulmonary rehabilitation in patients with COPD: the effect of program completion and change in incremental shuttle walking test distance.
journal contributionposted on 20.02.2019, 15:20 by Linzy Houchen-Wolloff, Johanna E. A. Williams, Ruth H. Green, Gerrit Woltmann, Michael C. Steiner, Louise Sewell, Michael D. L. Morgan, Sally J. Singh
Rationale: Pulmonary rehabilitation (PR) in patients with COPD has consistently been shown to produce benefits in exercise capacity, symptoms, and health status. The data surrounding survival following PR are less clear. Our aims were to compare the long-term survival in two cohorts of patients referred for PR; those who successfully completed PR, and a comparator group constructed from patients who either did not complete PR or did not start the program. Additionally, we compared survival between those people who were able to achieve a clinically meaningful improvement in exercise capacity (incremental shuttle walking test) following PR with those who were not. Methods: A retrospective longitudinal analysis of clinical service outcomes was conducted to compare the long-term survival in "completers" and "non-completers" of rehabilitation at two hospitals within the University Hospitals of Leicester NHS Trust from January 1, 2000 to February 23, 2012. For "completers", we also analyzed survival in those meeting (and not meeting) the desired level of change in the incremental shuttle walking test (≥50 m vs <50 m). Results: We present to you the largest dataset on this topic (n=1,515). Survival data were ascertained for 823 (54.3%) patients with COPD who had completed a course of PR and for 692 (45.7%) patients who dropped out. Survival time was significantly greater in "completers" compared to "non-completers" of PR (p<0.001). In addition, PR success (≥50 m change in walking distance) was also associated with improved survival (p<0.05). Conclusion: The data show an association between completion of PR and survival. In addition, PR success (>50 m change in walking distance) was also associated with improved survival.
CitationInternational Journal of Chronic Obstructive Pulmonary Disease, 2018:13, pp. 37-44
Author affiliation/Organisation/COLLEGE OF LIFE SCIENCES/School of Medicine/Department of Infection, Immunity and Inflammation
VersionVoR (Version of Record)
Published inInternational Journal of Chronic Obstructive Pulmonary Disease
PublisherDove Medical Press
COPDexercisesurvivalAgedEnglandExercise TherapyExercise ToleranceFemaleHealth StatusHospitals, UniversityHumansKaplan-Meier EstimateLongitudinal StudiesLungMaleMiddle AgedPatient CompliancePatient Education as TopicPredictive Value of TestsProportional Hazards ModelsPulmonary Disease, Chronic ObstructiveRecovery of FunctionRetrospective StudiesRisk FactorsSelf-ManagementTime FactorsTreatment OutcomeWalk Test