Physical frailty in COPD patients with chronic respiratory failure

Abstract

<b>Background:</b> The prevalence of physical frailty and its clinical features in advanced chronic obstructive pulmonary disease (COPD) is unknown, as well as the usefulness of functional tests to screen for physical frailty. We aimed to evaluate i) the proportion and clinical portrait of COPD patients with chronic respiratory failure exhibiting physical frailty when starting pulmonary rehabilitation, ii) the usefulness of the short physical performance battery (SPPB), gait speed (GS), and timed-up and go (TUG) as potential screening tools for physical frailty. <b>Methods:</b> It was a prospective observational study in which physical frailty was defined using Fried criteria. Daily physical activity, exercise tolerance, functional capacity, anxiety and depression symptoms and health related quality of life were assessed. The ability of the SPPB, GS, and TUG to predict physical frailty was investigated using receiver operating characteristics curves and odds ratio. <b>Results:</b> Amongst the 44 included participants, 19 (43%) were physically frail. Frail individuals had lower daily steps number, exercise tolerance and functional capacity, and higher fatigue and anxiety and depression symptoms (p&lt;0.05) scores compared to the non-frail individuals. Amongst the functional capacity tests, GS demonstrated the best predictive ability for physical frailty (AUC = 0.79; 78.9% sensitivity and 72.0% specificity). A GS ≤0.8 m/s was associated with a 10-fold increase in the odds of being physically frail. <b>Conclusion:</b> Physical frailty affects a large proportion of COPD patients with chronic respiratory failure, and was associated with worse clinical status. GS seems to have the potential to become a simple screening tool for physical frailty.