Survival prediction in patients with chronic obstructive pulmonary disease following a pulmonary rehabilitation programme in Hong Kong.

Cherry Wl Lau, Thomas Mok, William Wn Ko, Bobby Hp Ng, Irene Hl Chan, Teresa Ts Tsui, S O Ling, H Y Kwan, Y N Poon, C W Yim, P Y Yau
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Abstract

Background and objective: Pulmonary rehabilitation programme (PRP) is an important component in the management of chronic obstructive pulmonary disease (COPD). However, to date so far there has been limited literature on the survival outcomes of patients with COPD after a PRP in Hong Kong. This study aimed to investigate the outcomes of a pulmonary rehabilitation programme on the survival rates of a retrospective cohort of patients with COPD.

Methods: This was a retrospective study that included subjects who participated in the PRP in a rehabilitation hospital from the year 2003 to 2015. A total of 431 patients with chronic obstructive pulmonary disease were identified from the electronic record system of the hospital. The dataset were split into two age groups for reporting and analysis using the mean age of 72 as the cut-off. Their median survival times were calculated using Kaplan-Meier analysis. Cox-proportional regression model was used to explore factors that predicted better survival. The most significant predictors were used as strata, and their respective effects on survival functions were analysed with Kaplan-Meier analysis again.

Results: The overall median survival of the cohort was 4.3 years. The median survival times of the younger patient group (aged <72) and the older patient group (aged ≥72) were 5.3 and 3.6 years, respectively. For the patients, aged <72 years old, Moser's Activities of Daily Living class and the pulmonary rehabilitation programme completion rate were the most significant survival predictors. For the patients aged ≥72 years old, Monitored Functional Task Evaluation score was the most significant survival predictor.

Conclusion: Moser's Activities of Daily Living class ≥2 and non-completion of PRP for younger group, low exercise capacity with Monitored Functional Task Evaluation score <17 for older group were identified as significant predictors of poor survival. The findings of this study helped identifying those patients with COPD who have the needs to be more intensively treated and closely monitored.

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香港慢性阻塞性肺疾病患者肺康复计划后的生存预测
背景与目的:肺康复计划(PRP)是慢性阻塞性肺疾病(COPD)治疗的重要组成部分。然而,到目前为止,关于香港COPD患者PRP后的生存结果的文献有限。本研究旨在探讨肺部康复方案对COPD患者回顾性队列生存率的影响。方法:本研究为回顾性研究,纳入2003年至2015年在某康复医院参加PRP的受试者。从该院电子病历系统中共识别出431例慢性阻塞性肺疾病患者。数据集分为两个年龄组进行报告和分析,以平均年龄72岁为截止年龄。采用Kaplan-Meier分析计算中位生存时间。采用cox -比例回归模型探讨预测生存率提高的因素。将最显著的预测因子作为地层,再用Kaplan-Meier分析法分析其各自对生存函数的影响。结果:该队列的总中位生存期为4.3年。结论:低年组Moser's Activities of Daily Living class≥2,PRP未完成,运动能力低,监测功能任务评估评分
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