Risk factors of readmission to hospital for a COPD exacerbation: a prospective study
TLDR
This is the first study to show a strong association between usual physical activity and reduced risk of readmission to hospital with COPD, which is potentially relevant for rehabilitation and other therapeutic strategies.Abstract:
Background: Exacerbations of chronic obstructive pulmonary disease (COPD) are a leading cause of admission to hospital among men in many countries, although the factors causing exacerbations are largely unknown. The association between readmission for a COPD exacerbation and a wide range of modifiable potential risk factors, after adjusting for sociodemographic and clinical factors, has been assessed. Methods: Three hundred and forty patients with COPD recruited during an admission for an exacerbation in four tertiary hospitals in the Barcelona area of Spain were followed for a mean period of 1.1 years. Information on potential risk factors, including clinical and functional status, medical care and prescriptions, medication adherence, lifestyle, health status, and social support, was collected at the recruitment admission. A Cox’s proportional hazards model was used to obtain independent relative risks of readmission for COPD. Results: During the follow up period 63% of patients were readmitted at least once, and 29% died. The final multivariate model showed the following risk (or protective) factors: ⩾3 admissions for COPD in the year before recruitment (hazard ratio (HR)=1.66, 95% CI 1.16 to 2.39), forced expiratory volume in 1 second (FEV 1 ) percentage predicted (0.97, 95% CI 0.96 to 0.99), oxygen tension (0.88, 95% CI 0.79 to 0.98), higher levels of usual physical activity (0.54, 95% CI 0.34 to 0.86), and taking anticholinergic drugs (1.81, 95% 1.11 to 2.94). Exposure to passive smoking was also related to an increased risk of readmission with COPD after adjustment for clinical factors (1.63, 95% CI 1.04 to 2.57) but did not remain in the final model. Conclusions: This is the first study to show a strong association between usual physical activity and reduced risk of readmission to hospital with COPD, which is potentially relevant for rehabilitation and other therapeutic strategies.read more
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An official American thoracic society/European respiratory society statement: Key concepts and advances in pulmonary rehabilitation
Martijn A. Spruit,Sally J Singh,Chris Garvey,Richard ZuWallack,Linda Nici,Anne E Holland,Suzanne C. Lareau,Fabio Pitta,Louise Sewell,Jo Raskin,Jean Bourbeau,Rebecca Crouch,Frits M.E. Franssen,Richard Casaburi,Jan H. Vercoulen,Ioannis Vogiatzis,Rik Gosselink,Enrico Clini,Tanja Effing,Job van der Palen,Thierry Troosters,Daisy J.A. Janssen,Eileen G. Collins,Judith Garcia-Aymerich,Dina Brooks,Bonnie Fahy,Milo A. Puhan,Martine Hoogendoorn,Rachel Garrod,Annemie M. W. J. Schols,Brian W. Carlin,Roberto P. Benzo,Mike Morgan,Andrew L. Ries,Roger S. Goldstein,Claire A. Dowson,Jan Brozek,Claudio F. Donner,Emiel F.M. Wouters +38 more
TL;DR: The considerable growth in the science and application of pulmonary rehabilitation since 2006 adds further support for its efficacy in a wide range of individuals with chronic respiratory disease.
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Characteristics of Physical Activities in Daily Life in Chronic Obstructive Pulmonary Disease
Fabio Pitta,Thierry Troosters,Martijn A. Spruit,Vanessa S. Probst,Marc Decramer,Rik Gosselink +5 more
TL;DR: Physical activities and movement intensity in patients with chronic obstructive pulmonary disease are assessed with the DynaPort activity monitor and functional exercise capacity is the strongest correlate of physical activities in daily life.
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Regular physical activity reduces hospital admission and mortality in chronic obstructive pulmonary disease: a population based cohort study
TL;DR: The recommendation that COPD patients be encouraged to maintain or increase their levels of regular physical activity should be considered in future COPD guidelines, since it is likely to result in a relevant public health benefit.
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Mortality in COPD: Role of comorbidities.
TL;DR: The current paper reviews the role of comorbidities in chronic obstructive pulmonary disease mortality, the putative underlying pathogenic link between chronic obstructives pulmonary disease and comorbrid conditions (i.e. inflammation), and the tools used to predict Chronic obstructivemonary disease mortality.
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COPD exacerbations: defining their cause and prevention.
TL;DR: The future of exacerbation prevention is in assessment of optimum combinations of pharmacological and non-pharmacological therapies that will result in improvement of health status, and reduction of hospital admission and mortality associated with COPD.
References
More filters
Book
Applied Logistic Regression
David W. Hosmer,Stanley Lemeshow +1 more
TL;DR: Hosmer and Lemeshow as discussed by the authors provide an accessible introduction to the logistic regression model while incorporating advances of the last decade, including a variety of software packages for the analysis of data sets.
Journal ArticleDOI
Applied Logistic Regression.
TL;DR: Applied Logistic Regression, Third Edition provides an easily accessible introduction to the logistic regression model and highlights the power of this model by examining the relationship between a dichotomous outcome and a set of covariables.
Journal ArticleDOI
Compendium of physical activities: classification of energy costs of human physical activities.
Barbara E. Ainsworth,William L. Haskell,Arthur S. Leon,David R. Jacobs,Henry J. Montoye,James F. Sallis,Ralph S. Paffenbarger +6 more
TL;DR: In this article, a coding scheme for classifying physical activity by rate of energy expenditure, i.e., by intensity, was presented for classification of physical activity using five digits that classify activity by purpose (i.e. sports, occupation, sel
Standards for the Diagnosis and Care of Patients with Chronic Obstructive Pulmonary Disease
Bartolome R. Celli,Gordon L. Snider,John E. Heffner,Brian Tiep,Irwin Ziment,Barry J. Make,Sidney Braman,Gerald Olsen,Yancy Y. Phillips +8 more
TL;DR: Values below this suggest that further studies, such as split func-tion assessment by quantitative lung scintigraphy and exercisetesting, are warranted, and that all elective surgery Prophylaxis against deep venous throm-bosis should be given before most procedures that will require postoperative bed rest or significantly reduce mobility.
Book
Chronic obstructive pulmonary disease
TL;DR: The most important bacterial causes of exacerbations of COPD are nontypeable Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae and Chlamydia pneumoniae.