Survival after inpatient or outpatient pulmonary rehabilitation in patients with fibrotic interstitial lung disease : a multicentre retrospective cohort study
© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ..
BACKGROUND: The impact of pulmonary rehabilitation (PR) on survival in patients with fibrotic interstitial lung disease (ILD) is unknown. Given the challenges conducting a large randomised controlled trial, we aimed to determine whether improvement in 6-minute walk distance (6MWD) was associated with better survival.
METHODS: This retrospective, international cohort study included patients with fibrotic ILD participating in either inpatient or outpatient PR at 12 sites in 5 countries. Multivariable models were used to estimate the association between change in 6MWD and time to death or lung transplantation accounting for clustering by centre and other confounders.
RESULTS: 701 participants (445 men and 256 women) with fibrotic ILD were included. The mean±SD ages of the 196 inpatients and 505 outpatients were 70±11 and 69±12 years, respectively. Baseline/changes in 6MWD were 262±128/55±83 m for inpatients and 358±125/34±65 m for outpatients. Improvement in 6MWD during PR was associated with lower hazard rates for death or lung transplant on adjusted analysis for both inpatient (HR per 10 m 0.94, 95% CI 0.91 to 0.97, p<0.001) and outpatient PR (HR 0.97, 95% CI 0.95 to 1.00, p=0.042). Participation in ≥80% of planned outpatient PR sessions was associated with a 33% lower risk of death (95% CI 0.49% to 0.92%).
CONCLUSIONS: Patients with fibrotic ILD who improved physical performance during PR had better survival compared with those who did not improve performance. Confirmation of these hypothesis-generating findings in a randomised controlled trial would be required to definitely change clinical practice, and would further support efforts to improve availability of PR for patients with fibrotic ILD.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:77 |
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| Enthalten in: |
Thorax - 77(2022), 6 vom: 14. Juni, Seite 589-595 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Guler, Sabina Anna [VerfasserIn] |
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| Links: |
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| Themen: |
Exercise |
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| Anmerkungen: |
Date Completed 19.05.2022 Date Revised 07.07.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1136/thoraxjnl-2021-217361 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM330051059 |
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| 100 | 1 | |a Guler, Sabina Anna |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Survival after inpatient or outpatient pulmonary rehabilitation in patients with fibrotic interstitial lung disease |b a multicentre retrospective cohort study |
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| 500 | |a Date Revised 07.07.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ. | ||
| 520 | |a BACKGROUND: The impact of pulmonary rehabilitation (PR) on survival in patients with fibrotic interstitial lung disease (ILD) is unknown. Given the challenges conducting a large randomised controlled trial, we aimed to determine whether improvement in 6-minute walk distance (6MWD) was associated with better survival | ||
| 520 | |a METHODS: This retrospective, international cohort study included patients with fibrotic ILD participating in either inpatient or outpatient PR at 12 sites in 5 countries. Multivariable models were used to estimate the association between change in 6MWD and time to death or lung transplantation accounting for clustering by centre and other confounders | ||
| 520 | |a RESULTS: 701 participants (445 men and 256 women) with fibrotic ILD were included. The mean±SD ages of the 196 inpatients and 505 outpatients were 70±11 and 69±12 years, respectively. Baseline/changes in 6MWD were 262±128/55±83 m for inpatients and 358±125/34±65 m for outpatients. Improvement in 6MWD during PR was associated with lower hazard rates for death or lung transplant on adjusted analysis for both inpatient (HR per 10 m 0.94, 95% CI 0.91 to 0.97, p<0.001) and outpatient PR (HR 0.97, 95% CI 0.95 to 1.00, p=0.042). Participation in ≥80% of planned outpatient PR sessions was associated with a 33% lower risk of death (95% CI 0.49% to 0.92%) | ||
| 520 | |a CONCLUSIONS: Patients with fibrotic ILD who improved physical performance during PR had better survival compared with those who did not improve performance. Confirmation of these hypothesis-generating findings in a randomised controlled trial would be required to definitely change clinical practice, and would further support efforts to improve availability of PR for patients with fibrotic ILD | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a exercise | |
| 650 | 4 | |a idiopathic pulmonary fibrosis | |
| 650 | 4 | |a interstitial fibrosis | |
| 650 | 4 | |a pulmonary rehabilitation | |
| 700 | 1 | |a Hur, Seo Am |e verfasserin |4 aut | |
| 700 | 1 | |a Stickland, Michael K |e verfasserin |4 aut | |
| 700 | 1 | |a Brun, Patrick |e verfasserin |4 aut | |
| 700 | 1 | |a Bovet, Luc |e verfasserin |4 aut | |
| 700 | 1 | |a Holland, Anne E |e verfasserin |4 aut | |
| 700 | 1 | |a Bondarenko, Janet |e verfasserin |4 aut | |
| 700 | 1 | |a Hambly, Nathan |e verfasserin |4 aut | |
| 700 | 1 | |a Wald, Joshua |e verfasserin |4 aut | |
| 700 | 1 | |a Makhdami, Nima |e verfasserin |4 aut | |
| 700 | 1 | |a Kreuter, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Gloeckl, Rainer |e verfasserin |4 aut | |
| 700 | 1 | |a Jarosch, Inga |e verfasserin |4 aut | |
| 700 | 1 | |a Tan, Benjamin |e verfasserin |4 aut | |
| 700 | 1 | |a Johannson, Kerri A |e verfasserin |4 aut | |
| 700 | 1 | |a McBride, S Ainslie |e verfasserin |4 aut | |
| 700 | 1 | |a De Boer, Kaissa |e verfasserin |4 aut | |
| 700 | 1 | |a Sandoz, Jacqueline S |e verfasserin |4 aut | |
| 700 | 1 | |a Sun, Kelly |e verfasserin |4 aut | |
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| 700 | 1 | |a Bhatt, Surya P |e verfasserin |4 aut | |
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| 700 | 1 | |a Ryerson, Christopher J |e verfasserin |4 aut | |
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