Figures
- Fig. 1—
Description of the observational study of pulmonary rehabilitation (PR) offered to patients with chronic obstructive pulmonary disease.
- Fig. 2—
Distribution of the change in BODE index in all patients completing pulmonary rehabilitation (3 months). Improvement in the BODE is manifested by decreases in the index, whereas an increase in the value implies worsening in the prognosis. Over 70% of the patients had an improvement of at least one unit in the BODE index.
- Fig. 3—
All-cause and respiratory mortality at 2 yrs in patients with no pulmonary rehabilitation (PR; ▒), PR nonresponder patients (
) and PR responder patients (░). - Fig. 4—
Kaplan-Meier survival curves for all patients. Patients participating in pulmonary rehabilitation (○) manifested a survival advantage compared with patients who declined participation in pulmonary rehabilitation (•). p<0.0001 by log rank.
Tables
- Table. 1—
Baseline clinical characteristics of the patients according to their participation in pulmonary rehabilitation (PR)
No PR All PR p-value Patients n 130 116 Age yrs 69.5±8.7 69.5±7.7 0.79 FEV1 L 0.93±0.29 1.05±0.3 0.21 FEV1 % Pred 29.9±9.1 33.3±8.6 0.03 MMRC dyspnoea scale 3.15±0.76 2.65±0.63 <0.0001 6MWD m 229.3±113 343.1±100 <0.0001 BMI kg·m−2 24.5±5.8 26.8±5.5 0.005 BODE index 6.94±1.97 5.07±1.5 <0.0001 Charlson index 5±2.13 4.53±1.93 0.06 Chronic O2 use % 61.8 50 <0.001 Chronic steroid use % 16.7 7.7 <0.01 Pa,O2 mmHg 68.4±11 71±11 0.10 Pa,CO2 mmHg 42.7±7.8 40.9±6.6 0.12 O2 saturation with exercise 87.2±6 89.7±4.8 0.02 Chronic bronchitis % 53 59 0.12 Current tobacco use at entry % 29.7 27 0.001 Smoking Hx Packs·yr−1 93.7±53 91.3±43 0.24 Data presented as mean±sd, unless otherwise stated. FEV1: forced expiratory volume in one second; % pred: percentage of predicted; MMRC: Modified Medical Research Council; 6MWD: 6-minute walk distance; BMI: body mass index; Pa,O2: arterial oxygen tension; Pa,CO2: carbon dioxide arterial tension; Hx: history.
- Table. 2—
Change in BODE following pulmonary rehabilitation (PR) in the patients enrolled in PR as well as the change in patients who did not enrol in rehabilitation (no PR)
Groups Subjects n Baseline Post-PR (3 months) 1 yr 2 yrs No PR 130 6.94±1.97 6.81±1.92 6.58±2.1 7.22±2¶ PR# 116 5.07±1.5 4.18±1.68¶ 5.0±2.1 5.11±2.3¶ #: p<0.001 between no PR and PR at all time points; ¶: p<0.001 by ANOVA compared with baseline.
- Table. 3—
Hospitalisation rate and length of hospital stay 1 yr prior to and 1 yr after enrolment in all patients participating in the study
All no PR PR Total/COPD yr Pre 0.56±1.07 0.49±0.91 Post 0.42±1.21 0.26±00.79#, ¶ Total COPD LOS days Pre 3.71±6.7 1.81±4.8# Post 4.62±9.9 1.45±6.23#,¶ Data presented as mean±sd. PR: pulmonary rehabilitation; COPD: admissions due to chronic obstructive pulmonary disease exacerbations; LOS: length of hospital stay. #: p<0.005 PR compared with no PR by t-test for independent variables; ¶: p<0.001 post-rehabilitation compared with pre-rehabilitation by t-test for paired observations.
- Table. 4—
Mortality at 2 yrs in patients who participated in pulmonary rehabilitation (PR) compared with nonparticipants, independent of the severity of disease as measured by the BODE index
BODE quartile No PR# PR¶ p-value for difference in mortality BODE Mortality Patients n BODE Mortality Patients n Q2 3.88 24% 17 3.64 0% 45 <0.0001 Q3 5.53 30% 40 5.38 15% 52 <0.0001 Q4 8.4 71% 74 7.26 26% 19 <0.0001 #: n = 130; overall mortality 52%; ¶: n = 116; overall mortality 12%.
- Table. 5—
Cox proportional hazard analysis for all patients enroled in the study with death as the dependent variable
Hazard ratio p-value BODE index 1.817 (1.715–2.14) <0.0001 Participation in PR 0.569 (0.324–0.999) 0.023 Charlson index 1.195 (1.018–1.492) 0.036 Age 0.953 (0.913–0.996) 0.05 Data presented as n (95% confidence interval), unless otherwise stated. PR: pulmonary rehabilitation.
