Six‐Minute Walk Distance in Patients With Severe End‐Stage COPD: ASSOCIATION WITH SURVIVAL AFTER INPATIENT PULMONARY REHABILITATION

• Autores: Kyle Enfield, Sally Gammon, Jennifer Floyd, Cassandra Falt, James Patrie, Thomas A. Platts-Mills, Jonathon D. Truwit, Y. Michael Shim
• Localización: Journal of Cardiopulmonary Rehabilitation and Prevention: JCRP, ISSN-e 1932-7501, Vol. 30, Nº. 3, 2010, págs. 195-202
• Idioma: inglés
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• Resumen

  • PURPOSE: To evaluate the relationship between the 6-minute walk distance (6MWD) and survival in a cohort of patients with severe end-stage chronic obstructive pulmonary disease (COPD) who received inpatient pulmonary rehabilitation (IPR) from 1995 to 2007.

    METHODS: We retrospectively analyzed 815 patients with severe end-stage COPD who received IPR. 6MWDs before and after IPR (pre-6MWD, post-6MWD) were compared to assess whether 6MWD was significantly changed after IPR. The Kaplan-Meier survival curves were constructed to show the relationship between survival and 6MWD. The age- and or comorbidities-adjusted Cox proportional hazard model was applied to assess association between the survival and the pre-6MWD, post-6MWD, or difference in 6MWD from the pre-6MWD to post-6MWD (Δ6MWD).

    RESULTS: Baseline demographics demonstrated a median age 74.0 years, mostly women (60.1%), and white (89.9%) patients with significant comorbid diseases who were most recently hospitalized in acute care facilities (95.1%). IPR significantly increased the 6MWD (mean distance change: 86.4 m; 95% confidence interval [CI], 81.5–91.3 m). Pre-6MWD was not significantly associated with survival. However, post-6MWD was significantly associated with age- and comorbidity-adjusted survival (post-6MWD hazard ratio = 1.336; 95% CI, 1.232–1.449 [post-6MWD x m relative to post-6MWD 2x m]), and Δ6MWD was also significantly associated with age-, comorbidities-, and pre–6MWD-adjusted survival (Δ6MWD hazard ratio = 1.337; 95% CI, 1.227–1.457 [Δ6MWD x m relative to Δ6MWD 2x m]).

    CONCLUSIONS: In patients with severe end-stage COPD, IPR significantly improved 6MWD, and the post-6MWD and Δ6MWD were positively associated with the length of survival.