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[老年慢性阻塞性肺疾病康复对住院率和运动耐量的影响:一项回顾性观察研究]

[Effects of Geriatric COPD rehabilitation on hospital admissions and exercise tolerance: a retrospective observational study].

作者信息

Blindenbach Stephanie, Vrancken Jisca W F A, van der Zeijden Hans, Reesink Herre J, Brijker Folkert, Smalbrugge Martin, Wattel Elizabeth M

机构信息

Novicare, Utrecht, Nederland.

AxionContinu, Utrecht, Nederland.

出版信息

Tijdschr Gerontol Geriatr. 2017 Jun;48(3):112-120. doi: 10.1007/s12439-017-0214-8.

Abstract

INTRODUCTION

Frail COPD patients are frequently not accepted for regular pulmonary rehabilitation programs due to low physical condition and functional limitations. Rehabilitation programs in nursing homes for geriatric patients with COPD have been developed. The effects of such programs are largely unknown.

AIMS

To assess the course of COPD-related hospital admissions and exercise tolerance in a cohort of frail COPD patients participating in geriatric COPD rehabilitation.

METHODS

Retrospective observational study with a follow up of 12 months after discharge from rehabilitation. COPD related hospital admission days were measured in the year before and after participating rehabilitation. Exercise tolerance was measured by the six minute walk test (6MWT) at admission and at discharge from rehabilitation.

RESULTS

Fifty-eight participants accomplished the rehabilitation program. Twelve patients died in the first year after discharge. The median number of hospital admission days in the year before participating rehabilitation was 21 (IQR 10-33). The first year after discharge this was decreased to a median of 6 (IQR 0-12). The 6MWT increased from 194 (SD 85) meters at admission to 274 (SD 95) meters at discharge (mean difference 80 m, SD 72; p < 0.05).

CONCLUSIONS

Geriatric COPD rehabilitation in a nursing home setting seems to reduce hospital admissions in frail COPD patients and to increase exercise tolerance.

摘要

引言

体弱的慢性阻塞性肺疾病(COPD)患者常因身体状况差和功能受限而无法参加常规的肺康复项目。针对老年COPD患者的养老院康复项目已被开发出来。此类项目的效果在很大程度上尚不清楚。

目的

评估参加老年COPD康复项目的体弱COPD患者队列中与COPD相关的住院情况及运动耐量的变化过程。

方法

进行一项回顾性观察研究,在康复出院后随访12个月。测量参加康复前后一年中与COPD相关的住院天数。通过入院时及康复出院时的六分钟步行试验(6MWT)来测量运动耐量。

结果

58名参与者完成了康复项目。12名患者在出院后的第一年死亡。参加康复前一年的住院天数中位数为21天(四分位间距10 - 33天)。出院后的第一年,这一数字降至中位数6天(四分位间距0 - 12天)。6MWT从入院时的194(标准差85)米增加至出院时的274(标准差95)米(平均差值80米,标准差72;p < 0.05)。

结论

养老院环境中的老年COPD康复似乎能减少体弱COPD患者的住院次数,并提高运动耐量。

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