RT Journal Article
SR Electronic
T1 Comorbidity clusters and changes in exercise capacity and health status following pulmonary rehabilitation (PR) in patients with COPD
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P3039
VO 44
IS Suppl 58
A1 Rafael Mesquita
A1 Lowie E.G.W. Vanfleteren
A1 Frits M.E. Franssen
A1 Janeli Sarv
A1 Ziad Taib
A1 Miriam Groenen
A1 Swetlana Gaffron
A1 Piet Bruijnzeel
A1 Emiel F.M. Wouters
A1 Fabio Pitta
A1 Martijn A. Spruit
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P3039.abstract
AB Background: The impact of comorbidities on changes in relevant outcomes following PR in COPD is unclear. We aimed to study the impact of comorbidity clusters on changes in exercise capacity and health status in patients with COPD undergoing PR.Methods: 213 patients (59% men; age 64±7 yrs; FEV1 51±17% pred) were previously classified into 5 clusters of objectively identified comorbidities: cluster 1 (n=67, less comorbidity), 2 (n=49, cardiovascular), 3 (n=44, cachectic), 4 (n=33, metabolic), or 5 (n=20, psychologic) (Vanfleteren et al. Am J Respir Crit Care Med 2013). Patients underwent state-of-the-art PR. 6-min walk test (6MWT), constant work rate test (CWRT) and St. George's Respiratory Questionnaire (SGRQ) were assessed before and after PR.Results: Table 1 presents the responses to PR.The proportion of patients above the minimum clinically important difference (MCID) for the 6MWT (≥25m) was higher in cluster 5 (84%) than in clusters 1 (44%), 2 (49%) and 4 (39%) (P<0.05 for all), but no differences were found for the CWRT (≥100s) or SGRQ (≥4 units). Significant results from logistic regression models are presented in Table 2.Conclusions: Comorbidity clusters can impact relevant outcomes in patients with COPD undergoing PR. Exercise capacity and health status are differently influenced by these clusters. Subjects with anxiety or depression may benefit more from PR.