Effect of reduced physical activity on long-term survival and mortality of patients with advanced COPD
Abstract
Introduction: COPD is a serious heterogeneous disease in which increasing prevalence and mortality have been observed in recent decades. One of the possible and well-described predictors of mortality is physical activity.
The aim of our study was to determine the effect of reduced physical activity on long-term survival and mortality of patients with advanced COPD by measuring the ten-minute walk test (6MWT). Material and methods: Data of 598 patients from the Czech multicenter research database COPD were analyzed (four-year analysis).
This was an unselected group of patients with COPD, with a postbronchodilator value of forced expiratory volume in 1 second (post-BDT FEV1) = 300 meters. Receiver Operating Characteristic (ROC) analyzes and Kaplan Meier survival curves were used to determine the ideal cut-off distance and to estimate long-term survival and mortality.
Results: 6MWT was performed in a total of 598 patients (N = 598), the average distance traveled was 331.3 meters (standard deviation - SD 131.7). There were 57 patients (9.5%) in group I., in group II. there were 144 patients (24.1%) and in group III. 397 patients (66.4%).
The overall 4-year mortality was 25.4% (N = 152). Mortality was 50.9% in group I. (N = 29; 0.362; CI 0.198-0.525), in group II. 31.9% (N = 46; 0.572; CI 0.461-0.683) and in group III. 19.4% (N = 77; 0.726; CI 0.668-0.785), p = 325 meters was 59 patients - 17.0%.
The 4-year survival estimate was statistically significantly reduced in the group of patients with 6MWT <325 meters (0.494; CI 0.407-0.581 versus 0.763; CI 0.704-0.823), p <0.001. Conclusion: The results of our work are in consensus with the results of other studies.
As the distance traveled decreases, the risk of mortality increases significantly. 6MWT is a good predictor of mortality in patients with COPD.