Influence of changes in physical activity on frequency of hospitalization in chronic obstructive pulmonary disease
Influence of changes in physical activity on frequency of hospitalization in chronic obstructive pulmonary disease
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DOI：
10.1111/resp.12239
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发表时间：
2014-04-01
期刊：
影响因子：
6.9
通讯作者：
Capelastegui, Alberto
中科院分区：
文献类型：
--
作者：
Esteban, Cristobal;Arostegui, Inmaculada;Capelastegui, Alberto
[背景与目的]探讨慢性阻塞性肺疾病(COPD)患者常规体力活动(PA)改变对COPD急性加重期(ECOPD)住院率的影响。PA由患者自行报告，并通过他们每周至少3天的步行距离(公里/天)来确定。住院人数从医院数据库中记录下来。所有登记后至少随访两年的患者都包括在分析中。反应变量是在研究登记后2-5年的3年内因慢性阻塞性肺疾病住院的次数。1s平均用力呼气量为预测值的52%(14%)。维持较低PA水平的患者住院率较高(优势比1.901；95%可信区间1.090-3.317)。在PA达到最高水平后，在随访中降低PA的患者的住院率增加(优势比2.134；95%可信区间1.146~3.977)。结论低PA水平的COPD患者或随着时间的推移PA降低的患者更有可能经历eCOPD住院率的显著增加。改变较高的PA水平或随着时间的推移保持中等或高水平的PA，以及低强度的活动，如每天至少步行3-6公里，可以降低eCOPD的住院率。这项研究调查了体力活动的变化是否对COPD恶化的住院有任何影响。我们发现，体力活动的变化与住院之间存在关联，增加或保持适度体力活动的患者因COPD恶化而住院的次数较少。
Background and objectiveTo evaluate whether changes in regular physical activity (PA) in patients with chronic obstructive pulmonary disease (COPD) affect the rate of hospitalizations for COPD exacerbation (eCOPD).MethodsFive hundred forty-three ambulatory clinic patients being treated for COPD were prospectively identified. PA was self-reported by patients, and the level was established by the distance they walked (km/day) at least 3 days per week. Hospitalizations were recorded from hospital databases. All patients with at least a 2-year follow-up after enrolment were included in the analysis. The response variable was the number of hospitalizations for eCOPD within the 3-year period from 2 to 5 years after study enrolment.ResultsThree hundred ninety-one survivors were studied. Mean forced expiratory volume in 1s was 52% (14%) of the predicted value. Patients who maintained a lower level of PA had an increased rate of hospitalization (odds ratio 1.901; 95% confidence interval 1.090-3.317). After having had the highest level of PA, those patients who decreased their PA in the follow-up showed an increasing rate of hospitalizations (odds ratio 2.134; 95% confidence interval 1.146-3.977).ConclusionsPatients with COPD with a low level of PA or who reduced their PA over time were more likely to experience a significant increase in the rate of hospitalization for eCOPD. Changes to a higher level of PA or maintaining a moderate or high level of PA over time, with a low intensity activity such as walking for at least 3-6km/day, could reduce the rate of hospitalizations for eCOPD.This study investigated if a change in physical activity had any influence on hospitalizations for COPD exacerbation. We found an association between the change in physical activity and hospitalizations, patients who increased or maintained a moderate level of physical activity had fewer hospitalizations for COPD exacerbation.