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. 2022 Jan-Dec:19:14799731221119810.
doi: 10.1177/14799731221119810.

The prognosis of pre-frail chronic obstructive pulmonary disease patients for hospitalizations and mortality depends on their level of functional physical performance

Francesc Medina-Mirapeix  1   2 , Roberto Bernabeu-Mora  2   3   4 , Mariano Gacto-Sánchez  1   2 , Joaquina Montilla-Herrador  1   2 , Pilar Escolar-Reina  1   2 , María Piedad Sánchez-Martínez  1   2
Affiliations

The prognosis of pre-frail chronic obstructive pulmonary disease patients for hospitalizations and mortality depends on their level of functional physical performance

Francesc Medina-Mirapeix et al. Chron Respir Dis. 2022 Jan-Dec.

Abstract

Objective: To determine if pre-frail Chronic obstructive pulmonary disease (COPD) patients with poor and non-poor performance in the five-repetition sit-to-stand test (5-STS) had a worse prognosis for hospitalization and mortality at 2 years and for mortality at 5 years than non-frail patients.

Methods: We prospectively included patients with stable COPD, between 40 and 80 years, from a hospital in Spain. Patients were classified according their performance on the 5-STS test and level of frailty. Timing, number of hospitalizations, length of stay, and timing and rate of mortality were outcome measures. Patients were followed for 2 years for exacerbations and for 5 years for mortality. Kaplan-Meier curves and univariate and multivariate Cox proportional-hazard analyses, ANOVA tests and univariate and multivariate linear and logistic regression models were used.

Results: Of the 125 patients included, 25.6% were pre-frail with poor performance, 57% pre-frail with non-poor performance, and 17.4% non-frail with non-poor performance. Pre-frail patients with poor performance had a higher number of hospitalizations (adjusted beta: 0.49; 95% CI: 0.01-0.96), mortality rates (odds ratio: 11.33; 95% CI: 1.15-110.81), and risk at 5 years (adjusted hazard ratio: 8.77; 95% CI: 1.02-75.51) than non-frail patients. Pre-frail patients with poor performance also had worse prognoses than non-frail patients with respect to length of hospital stays (increased by 4.16 days) and timing to first hospitalization (HR: 6.01) in unadjusted models, but not when adjusted.

Conclusion: The COPD prognosis of pre-frail patients with respect to the number of exacerbations with hospitalization and the timing and rate of mortality is dependent of functional performance.

Keywords: Chronic obstructive pulmonary disease; exacerbations; five-repetition sit-to-stand test; frailty; hospitalization; mortality; physical performance; pre-frailty; six-min walk test.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Cumulative incidence of time to first hospitalization stratified by the pre-frailty with poor and non-poor performance and non-frailty phenotype.
Figure 2.
Figure 2.
Kaplan-Meier curves for time to death stratified by the pre-frailty with poor and non-poor performance and non-frailty phenotype.
See this image and copyright information in PMC

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