Abstract
Background: Pulmonary rehabilitation aims to improve exercise capacity and symptoms in COPD. In Greater Glasgow and Clyde less than half of referred patients complete the programme. We aimed to assess the impact of completion on mortality and what variables may predict survival.
Method: A retrospective cohort study of patients referred between 2008 and 2009. Baseline variables noted; age, sex, diagnosis, Forced Expiratory Volume (FEV1), MRC dyspnoea score and smoking status. 6-minute walk distance (6MWD)/endurance shuttle walk test results plus Borg and quality of life scores, pre and post completion and mortality data were obtained.
Results: N = 1806. 55.8% female, 96.6% COPD, mean age 65.58 years and FEV1 47.42%. 47% patients completed. Multivariate analysis showed compared to completers, those not attending were 1.492 times more likely not to survive and those attending but not completing were 1.629 times more likely not to survive. Completing improved Borg and quality of life scores but these didn’t significantly affect mortality. Achieving a 40m improvement in 6MWD improved survival. Baseline smoking status, MRC grade, and FEV1 in completers didn’t affect survival.
Conclusion: We identified that completion of rehabilitation is associated with survival independent of age, sex, FEV1 or MRC Grade. No baseline characteristics in completers predicted survival. Completion improved Borg and quality of life scores but wasn’t associated with improved survival. Those achieving at least a 40m improvement in 6MWT had improved survival. Other health factors not recorded may impact ability to complete and survival, however we suggest focused work to improve completion may impact mortality.
- Copyright ©the authors 2017
