Acute exacerbation of COPD during pulmonary rehabilitation: outcomes and risk prediction

• Published in: International journal of chronic obstructive pulmonary disease 2018-01, Vol.13, p.1767-1774
• Main Authors: Herer, Bertrand, Chinet, Thierry
• Format: Article
• Language: English
• Subjects: Aged; Airway management; Airway obstruction; Antibiotics; Body mass index; Chronic obstructive lung disease; Chronic obstructive pulmonary disease; COPD; Disease Progression; Dyspnea; exacerbation; Exercise Tolerance; Female; Forced Expiratory Volume; Hospitalization; Hospitals; Humans; Male; Medical research; Medical tests; Middle Aged; multidimensional indices; Original Research; Patients; Prospective Studies; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulmonary Disease, Chronic Obstructive - rehabilitation; rehabilitation; Severity of Illness Index; Software; Spirometry; Statistical analysis; Vital Capacity; Walk Test
• ISSN: 1178-2005; 1176-9106; 1178-2005
• DOI: 10.2147/COPD.S163472

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. A 4-week PR program (PRP) was implemented for 125 consecutive patients with COPD. At baseline and PRP completion, we recorded the FEV , 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. Thirty-two episodes of AECOPD occurred. The COPD status was worse in patients with than without AECOPD at baseline (lower FEV , 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. The BODE and SCOPEX MIs help to predict the exacerbation risk during PR.