Elsevier

Respiratory Medicine

Volume 101, Issue 5, May 2007, Pages 1037-1040
Respiratory Medicine

Short Communication
Walking distance is a predictor of exacerbations in patients with chronic obstructive pulmonary disease

https://doi.org/10.1016/j.rmed.2006.09.020Get rights and content
Under an Elsevier user license
open archive

Summary

Background

Patients with chronic obstructive pulmonary disease (COPD) are responsible for a high utilisation of the health care resources, and the cost is expected to increase. Physiological measures of lung function often fail to describe the impact the symptoms have on exacerbations, days of hospitalisation, and on a patient's health.

Methods

Twenty-one patients (14 female) with COPD (65 years, 40–79 years) admitted to the Department of Respiratory Medicine in Uppsala, performed a pulmonary function test (FEV1% predicted=37) and health status measurement (St. Georges Respiratory Questionnaire, SGRQ) at discharge. Four to six weeks after discharge, when they were in a stable clinical condition, they performed an exercise test (Incremental Shuttle Walk Test, ISWT) to measure their exercise capacity.

Results

Nine of 21 patients (43%) were rehospitalised within 12 month. The mean distance walked in the ISWT was 174 m in patients who were hospitalised and 358 m in non-hospitalised patients (P<0.001). Oxygen saturation ⩽88% after the ISWT was found in 73% of hospitalised patients in contrast to only 22% in non-hospitalised patients (P<0.05). Activity related health status (SGRQ-activity) was higher (worse) in hospitalised patients than in non-hospitalised patients (75 vs. 50) (P<0.05). The association between walking distance and the risk of rehospitalisation was significant after adjusting for oxygen saturation and health status (hazard risk ratio 0.8 (0.67–0.97) per 10 m).

This study has shown that walking distance is a good and reliable predictor of rehospitalisations in moderately and severely disabled patients with COPD.

Keywords

Physical performance
Hospitalisation
Quality of life
COPD
Incremental Shuttle Walk Test

Cited by (0)