Abstract

BackgroundThe aim of this study was to examine retrospective survival in elderly chronic obstructive pulmonary disease (COPD) patients receiving three different pulmonary rehabilitation (PR) programs.Results193 patients [m / f 92 / 101, mean age 69.2 (standard deviation 8.6)] receiving PR were studied with lifetable and Cox regression analyses. Forced expiratory volume in 1 second (FEV1) % pred. was significantly different in the in-patient (n = 72), out-patient (n = 72), and maintenance group (n = 49) [mean 54.5 (21.8), 52.2 (17.7), and 42.9 (15.0), respectively (p = 0.004)]. PR days were 30.3 (20.4), 18.9 (10.4) and 30.0 (20.3), respectively (p < 0.001). Median survival rate was nine years in the in-patient, eight years in the out-patient and seven years in the maintenance group. Hospital stays and days were significantly increased in the maintenance group compared with the other groups (p = 0.003 and 0.010, respectively). The impact of evaluated variables on survival in the three PR groups was significant for age, FEV1 as well as the use of long-term oxygen therapy (LTOT) (HR 1.06, for five years, p < 0.001, HR 0.98, p = 0.01, and HR 2.18, p = 0.005, respectively).ConclusionsThe COPD patients in the maintenance group showed a worse survival, but after correction for gender, age and severity of obstruction, the difference was not statistically significant.

Highlights

  • The aim of this study was to examine retrospective survival in elderly chronic obstructive pulmonary disease (COPD) patients receiving three different pulmonary rehabilitation (PR) programs

  • Two of the patients included in the maintenance group showed a Forced expiratory volume in 1 second (FEV1) % predicted of 73.6 and 51.8, respectively, and received ambulatory oxygen therapy

  • Three long-term oxygen therapy (LTOT) patients with predominating emphysema were included in this group despite high values of FEV1 % predicted of 84, 77.8 and 72.2, because they suffered from severe chronic hypoxaemia with resting PaO2 levels of 6.41, 6.51 and 5.8 kPa, respectively

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Summary

Introduction

The aim of this study was to examine retrospective survival in elderly chronic obstructive pulmonary disease (COPD) patients receiving three different pulmonary rehabilitation (PR) programs. Pulmonary rehabilitation (PR) is a multidisciplinary intervention for the management of chronic obstructive pulmonary disease (COPD) [1,2,3]. Several previous studies have shown increased survival in patients with COPD receiving PR [11,12,13]. Only one prospective randomized, controlled study of PR has evaluated the effect on long-term survival. Ries and colleagues randomly assigned patients with COPD to either an 8-week comprehensive outpatient PR program (57 patient) or to a control group given educational sessions (62 patients).

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