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Six-minute walk distance in patients with severe end-stage COPD: Association with survival after inpatient pulmonary rehabilitation

机译:患有严重COPD终末期患者的六分钟步行距离:与住院肺康复后的存活率相关

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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.
机译:目的:评价1995年至2007年接受住院肺康复(IPR)的重症晚期慢性阻塞性肺疾病(COPD)患者队列中6分钟步行距离(6MWD)与存活率之间的关系。方法:我们回顾性分析了815例接受IPR治疗的重度COPD晚期患者。比较IPR前后的6MWD(6MWD之前,6MWD之后),以评估IPR后6MWD是否发生了显着变化。绘制Kaplan-Meier生存曲线以显示生存与6MWD之间的关系。应用年龄和/或合并症调整后的Cox比例风险模型评估生存率与6MWD之前,6MWD之后或6MWD之前与6MWD之后的6MWD之间的差异(Δ6MWD)。结果:基线人口统计数据显示,中位年龄为74.0岁,大多数为女性(60.1%)和白人(89.9%)患有严重合并症的患者,这些患者最近在急诊设施住院(95.1%)。 IPR显着增加了6MWD(平均距离变化:86.4 m; 95%置信区间[CI]为81.5-91.3 m)。 6MWD前与生存无显着相关性。然而,6MWD后与年龄和合并症调整后的存活率显着相关(6MWD后危险比= 1.336; 95%CI,1.232-1.449 [6MWD后xm相对于6MWD后2x m]),Δ6MWD为也与年龄,合并症和6MWD调整前的存活率显着相关(Δ6MWD危险比= 1.337; 95%CI,1.227-1.457 [Δ6MWDxm相对于Δ6MWD2x m])。结论:严重COPD终末期患者的IPR可明显改善6MWD,而6MWD后和Δ6MWD与生存期呈正相关。

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