AI Article Synopsis

  • A retrospective cohort study analyzed 20-year mortality rates among chronic respiratory disease patients who participated in pulmonary rehabilitation (PR) compared to matched controls, hypothesizing that PR improves long-term survival.
  • The study included 238 individuals in the PR program versus an equal number of controls, assessing demographics, clinical variables, and mortality outcomes using statistical analyses like Kaplan-Meier and Cox regression.
  • Results showed higher mortality risks in controls (HR=1.64) and revealed that patients in the PR program potentially had lower mortality compared to those not in PR, despite some limitations in the study's methodology.

Article Abstract

Background: Pulmonary rehabilitation (PR) is widely recommended for short-term benefits in chronic respiratory diseases, yet long-term outcomes remain uncertain. This retrospective cohort study addresses this gap, comparing 20-year mortality rates between PR participants and matched controls, and hypothesizing that the short-term benefits of PR contribute to improved long-term survival.

Methods: The 20-year mortality of stable chronic respiratory patients who participated in an outpatient PR program was compared with a matched control group based on the type of lung disease. Demographic and clinical variables, and the dates of deaths, were extracted and compared between two groups with two sample t-test and chi-square tests. Kaplan-Meier plots and Cox regression analyses were employed to evaluate survival differences.

Results: Between 2000 and 2002, 238 individuals enrolled in a pulmonary rehabilitation (PR) program (58% male, mean age ± SD: 69 ± 8 years, mean FEV% predicted ± SD: 46 ± 21%). An equal number of people with comparable lung disease were selected as controls (88% COPD, 5% ILD). Controls had lower FEV% predicted values (mean ± SD: 39 ± 17%, P < 0.001), smoked more (mean ± SD: 48 ± 35 pack-years, P = 0.032), and no differences in age, BMI, sex, and Index of Relative Socio-economic Advantage and Disadvantage (IRSAD). Median (IQR) follow-up time was 68 months (34-123), with 371 (78%) deaths. Univariable (HR = 1.71, p < 0.001) and multivariable (HR = 1.64, p < 0.001) Cox regression found higher mortality risk in controls. Subgroup analysis for COPD replicated these findings (HR = 1.70, P < 0.001).

Discussion: Despite some methodological limitations, our study suggests that clinically stable patients with chronic respiratory disease who undertake PR may have lower mortality than matched controls.

Trial Registration: Retrospectively registered.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465484PMC
http://dx.doi.org/10.1186/s12890-024-03319-9DOI Listing

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