Six-minute walk distance in patients with severe end-stage COPD: association with survival after inpatient pulmonary rehabilitation. J Cardiopulm Rehabil Prev 2010;30(3):195-202
Date
12/31/2009Pubmed ID
20040883Pubmed Central ID
PMC3047503DOI
10.1097/HCR.0b013e3181c565e4Scopus ID
2-s2.0-77952317158 (requires institutional sign-in at Scopus site) 33 CitationsAbstract
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 (Delta6MWD).
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 Delta6MWD was also significantly associated with age-, comorbidities-, and pre-6MWD-adjusted survival (Delta6MWD hazard ratio = 1.337; 95% CI, 1.227-1.457 [Delta6MWD x m relative to Delta6MWD 2x m]).
CONCLUSIONS: In patients with severe end-stage COPD, IPR significantly improved 6MWD, and the post-6MWD and Delta6MWD were positively associated with the length of survival.
Author List
Enfield K, Gammon S, Floyd J, Falt C, Patrie J, Platts-Mills TA, Truwit JD, Shim YMMESH terms used to index this publication - Major topics in bold
Age FactorsAged
Cohort Studies
Comorbidity
Exercise
Exercise Test
Female
Hospitalization
Humans
Kaplan-Meier Estimate
Male
Occupational Therapy
Physical Therapy Modalities
Proportional Hazards Models
Pulmonary Disease, Chronic Obstructive
Retrospective Studies
Severity of Illness Index
Walking
