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Functional Status and Survival in Patients With Chronic Obstructive Pulmonary Disease Following Pulmonary Rehabilitation
María Victorina López Varelaa,
, Turquesa Anidoa, María Larrosab
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mlopez@chasque.net
Correspondence: Dra. M.V. López Varela. 21 deSetiembre, 2353/301. 11200 Montevideo. Uruguay
Correspondence: Dra. M.V. López Varela. 21 deSetiembre, 2353/301. 11200 Montevideo. Uruguay
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"autoresLista" => "María Victorina López Varela, Turquesa Anido, María Larrosa" "autores" => array:3 [ 0 => array:5 [ "preGrado" => "Dra." "nombre" => "María Victorina" "apellidos" => "López Varela" "email" => array:1 [ 0 => "mlopez@chasque.net" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "Turquesa" "apellidos" => "Anido" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 2 => array:3 [ "nombre" => "María" "apellidos" => "Larrosa" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Departamento de Neumología. Centro de Asistencia del Sindicato Médico del Uruguay (CASMU), Montevideo. Uruguay, Member of Latin American Thoracic Society (ALAT)" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Departamento de Fisiatría, CASMU, Montevideo, Uruguay, Member of ALAT" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dra. M.V. López Varela. 21 deSetiembre, 2353/301. 11200 Montevideo. Uruguay" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2005-07-20" "fechaAceptado" => "2006-02-07" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec154533" "palabras" => array:3 [ 0 => "Pulmonary rehabilitation" 1 => "COPD" 2 => "Survival predictors" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec154532" "palabras" => array:3 [ 0 => "Rehabilitación respiratoria" 1 => "EPOC" 2 => "Predictores de supervivencia" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p class="elsevierStyleSimplePara elsevierViewall">To study functional status and survival in patients with chronic obstructive pulmonary disease (COPD) following a pulmonary rehabilitation program.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">We assessed lung function, 6-minute walk distance, Borg score for dyspnea upon completion of the 6-minute walk, workload in watts on a cycle ergometer, quality of life using the St George's Respiratory Questionnaire (SGRQ); the body-mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) index; and survival.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">One hundred five patients participated in the pulmonary rehabilitation program. The patients had a mean (SD) age of 63.9 (9.3) years, body mass index of 24.5 (4.56) kg/m<span class="elsevierStyleSup">2</span>, and forced expiratory volume in 1 second (FEV<span class="elsevierStyleInf">1</span>) of 0.91 (0.46) L. The mean distances walked in 6 minutes were 412.8 (79.4) m before the pulmonary rehabilitation program and 443.46 (81.57) m after rehabilitation. The mean workloads on the cycle ergometer before and after rehabilitation, respectively, were 47.9 (29.6) W and 77.76 (20.88) W. The mean Borg scores were 2.2 (1.37) before and 1.47 (1.37) after rehabilitation, and the SGRQ scores at the same times were 27.63 (16.02) and 25.45 (15.12). Mortality due to respiratory disease (105 months) was 19%. Cumulative survival rates at 1 year, 3 years, and 6 years were 91%, 86.7%, and 6.75%, respectively. Survival was related to an FEV<span class="elsevierStyleInf">1</span> greater than 1.02 L (<span class="elsevierStyleItalic">P</span>=.05), a 6-minute walk distance over 448 m before rehabilitation (<span class="elsevierStyleItalic">P</span>=.04) and 454 m after rehabilitation (<span class="elsevierStyleItalic">P</span>=.05), and a workload on the cycle ergometer of over 54 W before rehabilitation (<span class="elsevierStyleItalic">P</span>=.01) and 72 W (<span class="elsevierStyleItalic">P</span>=.02) afterwards. The correlations between survival and both SGRQ and BODE scores were weaker.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">We observed improved exercise capacity, dyspnea ratings, and, to a lesser extent, better SGRQ scores in our COPD patients following pulmonary rehabilitation. The best predictors of survival were FEV<span class="elsevierStyleInf">1</span>, the 6-minute walk distance, and the cycle ergometer workloads.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p class="elsevierStyleSimplePara elsevierViewall">Mostrar los resultados funcionales y la supervivencia de pacientes con enfermedad pulmonar obstructiva crónica (EPOC) tras un programa de rehabilitación respiratoria (RR).</p> <span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Se evaluaron la función pulmonar, la distancia recorrida en 6 min y la disnea según la escala de Borg en la prueba de la marcha de 6 min, carga en vatios sobre cicloergómetro y calidad de vida por el St. George's Respiratory Questionnaire (SGRQ), puntuación en el índice BODE y supervivencia.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Ingresaron en el programa de RR 105 pacientes, con una edad media ± desviación estándar de 63,9 ± 9,3 años, índice de masa corporal de 24,5 ± 4,56 y volumen espiratorio forzado en el primer segundo (FEV<span class="elsevierStyleInf">1</span>) de 0,91 ± 0,46 l/s. La distancia recorrida en 6 min antes de RR fue de 412,8 ± 79,4 m, y tras RR de 443,46 ± 81,57 m. La carga en cicloergómetro fue de 47,9 ± 29,6 W pre-RR y de 77,76 ± 20,88 W post-RR. La puntuación en la escala de Borg fue de 2,2 ± 1,37 pre-RR y de 1,47 ± 1,37 post-RR, y el SGRQ de 27,63 ± 16,02 y 25,45 ± 15,12, respectivamente. La mortalidad respiratoria (105 meses) fue del 19%. La supervivencia acumulada a 1, 3 y 6 años fue del 91, el 86,7 y el 67,5%, respectivamente, y se relacionó con un valor de FEV<span class="elsevierStyleInf">1</span> mayor de 1,02 l/s (p = 0,05), distancia recorrida en la prueba de la marcha de 6 min mayor de 448 m pre-RR (p = 0,04) y de 454 m post-RR (p = 0,05) y carga en cicloergómetro mayor de 54 W pre-RR (p = 0,01) y de 72 W post-RR (p = 0,02). La relación de la supervivencia con el SGRQ y el índice BODE fue menor.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La capacidad de ejercicio, la disnea y, en menor grado, la calidad de vida mejoraron con la RR en los pacientes con EPOC. Los mejores predictores de supervivencia fueron el FEV<span class="elsevierStyleInf">1</span>, la distancia recorrida en 6 min y los vatios alcanzados en el cicloergómetro.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:36 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 3 | 2 | 5 |
| 2024 October | 26 | 15 | 41 |
| 2024 September | 26 | 12 | 38 |
| 2024 August | 41 | 30 | 71 |
| 2024 July | 27 | 23 | 50 |
| 2024 June | 37 | 21 | 58 |
| 2024 May | 32 | 29 | 61 |
| 2024 April | 18 | 21 | 39 |
| 2024 March | 12 | 12 | 24 |
| 2024 February | 21 | 14 | 35 |
| 2023 March | 1 | 4 | 5 |
| 2023 February | 16 | 13 | 29 |
| 2023 January | 19 | 25 | 44 |
| 2022 December | 16 | 17 | 33 |
| 2022 November | 22 | 19 | 41 |
| 2022 October | 22 | 39 | 61 |
| 2022 September | 14 | 17 | 31 |
| 2022 August | 71 | 32 | 103 |
| 2022 July | 75 | 36 | 111 |
| 2022 June | 20 | 28 | 48 |
| 2022 May | 30 | 22 | 52 |
| 2022 April | 16 | 31 | 47 |
| 2022 March | 17 | 31 | 48 |
| 2022 February | 13 | 34 | 47 |
| 2022 January | 18 | 29 | 47 |
| 2021 December | 18 | 40 | 58 |
| 2021 November | 21 | 53 | 74 |
| 2021 October | 20 | 62 | 82 |
| 2021 September | 22 | 59 | 81 |
| 2021 August | 13 | 24 | 37 |
| 2021 July | 18 | 41 | 59 |
| 2021 June | 21 | 33 | 54 |
| 2021 May | 14 | 28 | 42 |
| 2021 April | 58 | 49 | 107 |
| 2021 March | 13 | 23 | 36 |
| 2021 February | 10 | 17 | 27 |
| 2021 January | 9 | 17 | 26 |
| 2020 December | 17 | 17 | 34 |
| 2020 November | 10 | 19 | 29 |
| 2020 October | 11 | 15 | 26 |
| 2020 September | 6 | 10 | 16 |
| 2020 August | 11 | 10 | 21 |
| 2020 July | 10 | 17 | 27 |
| 2020 June | 3 | 7 | 10 |
| 2020 May | 8 | 14 | 22 |
| 2020 April | 10 | 17 | 27 |
| 2020 March | 11 | 14 | 25 |
| 2020 February | 8 | 14 | 22 |
| 2020 January | 14 | 16 | 30 |
| 2019 December | 12 | 16 | 28 |
| 2019 November | 15 | 14 | 29 |
| 2019 October | 13 | 10 | 23 |
| 2019 September | 10 | 4 | 14 |
| 2019 August | 9 | 7 | 16 |
| 2019 July | 17 | 10 | 27 |
| 2019 June | 7 | 6 | 13 |
| 2019 May | 12 | 13 | 25 |
| 2019 April | 25 | 28 | 53 |
| 2019 March | 9 | 20 | 29 |
| 2019 February | 4 | 12 | 16 |
| 2019 January | 5 | 8 | 13 |
| 2018 December | 3 | 10 | 13 |
| 2018 November | 8 | 10 | 18 |
| 2018 October | 9 | 12 | 21 |
| 2018 September | 11 | 7 | 18 |
| 2018 May | 7 | 1 | 8 |
| 2018 April | 3 | 2 | 5 |
| 2018 March | 9 | 3 | 12 |
| 2018 February | 7 | 7 | 14 |
| 2018 January | 6 | 7 | 13 |
| 2017 December | 5 | 5 | 10 |
| 2017 November | 5 | 2 | 7 |
| 2017 October | 5 | 9 | 14 |
| 2017 September | 4 | 4 | 8 |
| 2017 August | 7 | 12 | 19 |
| 2017 July | 3 | 4 | 7 |
| 2017 June | 8 | 8 | 16 |
| 2017 May | 6 | 5 | 11 |
| 2017 April | 1 | 3 | 4 |
| 2017 March | 2 | 3 | 5 |
| 2017 February | 0 | 4 | 4 |
| 2017 January | 1 | 1 | 2 |
| 2016 December | 9 | 4 | 13 |
| 2016 November | 16 | 12 | 28 |
| 2016 October | 11 | 13 | 24 |
| 2016 September | 12 | 5 | 17 |
| 2016 August | 9 | 3 | 12 |
| 2016 July | 8 | 0 | 8 |
| 2016 March | 2 | 0 | 2 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 36 | 7 | 43 |
| 2015 September | 51 | 7 | 58 |
| 2015 August | 38 | 4 | 42 |
| 2015 July | 57 | 4 | 61 |
| 2015 June | 38 | 5 | 43 |
| 2015 May | 70 | 6 | 76 |
| 2015 April | 38 | 12 | 50 |
| 2015 March | 30 | 7 | 37 |
| 2015 February | 43 | 9 | 52 |
| 2015 January | 47 | 5 | 52 |
| 2014 December | 35 | 7 | 42 |
| 2014 November | 51 | 6 | 57 |
| 2014 October | 47 | 5 | 52 |
| 2014 September | 46 | 7 | 53 |
| 2014 August | 43 | 10 | 53 |
| 2014 July | 60 | 7 | 67 |
| 2014 June | 64 | 3 | 67 |
| 2014 May | 61 | 10 | 71 |
| 2014 April | 57 | 11 | 68 |
| 2014 March | 81 | 7 | 88 |
| 2014 February | 51 | 9 | 60 |
| 2014 January | 44 | 9 | 53 |
| 2013 December | 49 | 10 | 59 |
| 2013 November | 46 | 10 | 56 |
| 2013 October | 52 | 9 | 61 |
| 2013 September | 43 | 9 | 52 |
| 2013 August | 41 | 4 | 45 |
| 2013 July | 60 | 8 | 68 |
| 2013 June | 39 | 5 | 44 |
| 2013 May | 54 | 5 | 59 |
| 2013 April | 26 | 7 | 33 |
| 2013 March | 8 | 1 | 9 |
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