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Observational Study
. 2018 May 29:13:1767-1774.
doi: 10.2147/COPD.S163472. eCollection 2018.

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

Bertrand Herer  1 , Thierry Chinet  2
Affiliations
Observational Study

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

Bertrand Herer et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

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; exacerbation; multidimensional indices; rehabilitation.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Flowchart of patients who were enrolled in the study. Abbreviations: AECOPD, acute exacerbation of COPD; PRP, pulmonary rehabilitation program.
Figure 2
Figure 2
Receiver operating characteristic curves of three multidimensional indices predicting the occurrence of an exacerbation during pulmonary rehabilitation and of NEXA at their optimal threshold value. Note: Red dotted line: line of identity. Abbreviations: AECOPD, acute exacerbation of COPD; BODE1, BODE index at baseline; BODE, body mass index, airway obstruction, dyspnea, exercise capacity; DOSE, dyspnea, obstruction, smoking, exacerbation; NEXA, number of AECOPD episodes in the year preceding enrolment; SCOPEX, score to predict short-term risk of COPD exacerbations.
See this image and copyright information in PMC

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