Influence of comorbidities on the efficacy of pulmonary rehabilitation in patients with chronic obstructive pulmonary disease
Influence of comorbidities on the efficacy of pulmonary rehabilitation in patients with chronic obstructive pulmonary disease
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DOI：
10.1111/ggi.12575
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发表时间：
2016-08-01
影响因子：
3.3
通讯作者：
Tohda, Yuji
中科院分区：
文献类型：
--
作者：
Higashimoto, Yuji;Yamagata, Toshiyuki;Tohda, Yuji
目的：探讨慢性阻塞性肺疾病(COPD)患者的合并症和年龄对肺康复(PR)疗效的影响。共病信息是通过Charlson指数、BODE指数和COPD特异性共病试验收集的，还包括这些指数中未包括的其他常见情况。PR的疗效被定义为6分钟步行距离增加54米或圣乔治呼吸问卷得分下降4分。结果：52例患者中有21例(40%)通过6分钟步行距离获得临床显著益处，29例(55.8%)采用圣乔治呼吸问卷评分。老年组和青年组的PR疗效在这两个参数上均无差异。总共98%的患者至少有一种慢性合并症。高血压是最常见的共病(28.5%)。体重指数、医院焦虑和抑郁量表焦虑评分和圣乔治呼吸问卷总分越高，6min步行距离对PR的反应越好。各单项合并症或指标与PR疗效均无相关性。多因素Logistic回归分析显示体重指数与PR疗效独立相关。结论：PR对老年和青年COPD患者的疗效相同，疗效受体重指数和焦虑程度的影响。
Aim: To evaluate the influence of comorbidities and aging on pulmonary rehabilitation (PR) efficacy in patients with chronic obstructive pulmonary disease (COPD).Methods: This was a retrospective cohort study of patients with COPD attending an outpatient PR program. Comorbidity information was collected with the Charlson Index, BODE index and COPD-specific comorbidity test, and also included other common conditions not included in these indexes. The efficacy of PR was defined as a 54-m increase in 6-min walk distance or a four-point decrease in St. George's Respiratory Questionnaire score. Patients were divided into two age groups according to the median age of 72 years.Results: A total of 21 of 52 patients (40%) showed a clinically significant benefit by the 6-min walk distance, and 29 patients (55.8%) by the St. George's Respiratory Questionnaire score. PR efficacy was not different between the elderly group and the younger group by either parameter. A total of 98% of the patients had at least one chronic comorbidity. Hypertension was the most frequently reported comorbidity (28.5%). Higher body mass index, Hospital Anxiety and Depression Scale anxiety score and St. George's Respiratory Questionnaire total score were associated with a good response to PR by the 6-min walk distance. None of the individual comorbidities or indexes were correlated with the efficacy of PR. Multiple logistic regression analysis showed that body mass index was independently associated with the response to PR.Conclusions: PR is equally effective in elderly and younger patients with COPD, with efficacy influenced by body mass index and anxiety.