Acute exacerbation of COPD during pulmonary rehabilitation: outcomes and risk prediction
Authors Herer B, Chinet T
Received 23 January 2018
Accepted for publication 18 March 2018
Published 29 May 2018 Volume 2018:13 Pages 1767—1774
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Charles Downs
Peer reviewer comments 2
Editor who approved publication: Dr Richard Russell
Bertrand Herer,1 Thierry Chinet2
1Pulmonary Rehabilitation Unit, Pulmonary Department, Centre Hospitalier De Bligny, Briis sous Forges, France; 2Pneumology Unit, Hôpital A. Paré, Boulogne-Billancourt, France
Purpose: This study was performed to examine acute exacerbation of COPD (AECOPD) during pulmonary rehabilitation (PR) and the usefulness of multidimensional indices (MIs) to predict AECOPD at enrolment in PR.
Patients and methods: A 4-week PR program (PRP) was implemented for 125 consecutive patients with COPD. At baseline and PRP completion, we recorded the FEV1, 6-minute walk test, peak work rate at cardiopulmonary testing, modified Medical Research Council score, and COPD Assessment Test (CAT) score. The risk of AECOPDs at baseline was assessed using the body mass index, airway obstruction, dyspnea, Exercise capacity (BODE), dyspnea, obstruction, smoking, exacerbation (DOSE), and score to predict short-term risk of COPD exacerbations (SCOPEX) MIs.
Results: Thirty-two episodes of AECOPD occurred. The COPD status was worse in patients with than without AECOPD at baseline (lower FEV1, 6-minute walk test, and peak work rate; higher modified Medical Research Council and CAT scores). The sensitivities of the BODE, DOSE, and SCOPEX MIs to predict the occurrence of AECOPD during PRP were 78.1%, 21.9%, and 84.4%, and the specificities were 73.6%, 87.1%, and 51.6%, respectively.
Conclusion: The BODE and SCOPEX MIs help to predict the exacerbation risk during PR.
Keywords: COPD, rehabilitation, exacerbation, multidimensional indices
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