Physical activity after discharge following chronic obstructive pulmonary disease (COPD) or congestive heart failure (CHF) exacerbations

Abstract

Background: Lower physical activity in COPD predicts increased health care utilization. Activity after a CHF exacerbation may be low and may also predict health care utilization. Objective: Compare post-discharge physical activity in CHF and COPD. Methods: We measured activity over 1 month (using tri-axial accelerometers on the wrist) in 37 discharged after a hospitalization for CHF. Minutes per day above 3000 vector magnitude units (sum of movements per minute in 3 planes) from the wrist device were analyzed; this corresponds to light-moderate intensity. Physical activity was compared with that from 38 discharged COPD patients from a similarly-designed earlier study. We then evaluated activity as a predictor of 30-day, all-cause hospital re-admissions in both diseases. Results: Re-admissions in CHF and COPD were 32 and 24%, respectively. Overall, higher-intensity activity in CHF and COPD were similar over 4 weeks, and, in both, physical activity was lower in those eventually re-admitted (Figure 1). Lower activity tended to predict readmission in both diseases: odds ratio (CHF) = 5.0 and (COPD) = 6.7 (p = 0.05 and 0.02, respectively). Conclusions: Physical activity post-discharge is similar in CHF and COPD, and predicts 30-day all-cause hospital re-admissions in both. At present, we do not know how these activity levels compare to those of healthy controls.