Komatsu Teruya, Oshima Ayako, Chen-Yoshikawa Toyofumi F, Harashima Shin-Ichi, Aoyama Akihiro, Inagaki Nobuya, Date Hiroshi
Department of Thoracic Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
Department of Metabolism and Clinical Nutrition, Kyoto University, Kyoto, Japan.
Surg Today. 2017 Dec;47(12):1526-1532. doi: 10.1007/s00595-017-1542-6. Epub 2017 May 24.
Our objective was to investigate the factors predicting the survival of patients on the waiting list for lung transplantation (LT) during the waiting period, with a special emphasis on the physical activity level.
The study included 70 patients with end-stage pulmonary disease who were on the waiting list for LT at Kyoto University Hospital. We examined the association between the baseline characteristics, including the body mass index and body composition, serum albumin, serum C-reactive protein (CRP), steroid administration, physical activity level (calculated by the food frequency questionnaire) and survival during the waiting period using Kaplan-Meier curves and Cox proportional hazard regression models.
A physical activity level of ≤1.2 was correlated with significantly decreased survival (1-year survival: 68 vs. 90.9%, p = 0.0089), with a hazard ratio (HR) of 2.24 (95% confidence interval (CI) 1.22-4.19, p = 0.0001). Hypo-albumin (HR 2.024, 95% CI 1.339-6.009, p = 0.004), a high level of CRP (HR 2.551, CI 1.229-4.892, p = 0.02), and the administration of steroids (HR 2.258, CI 1.907-5.032, p = 0.024) were also significant predictors of survival.
Low levels of physical activity during the waiting period for LT led to decreased survival times among LT candidates.
我们的目标是研究在等待期内预测肺移植（LT）等待名单上患者生存的因素，特别强调身体活动水平。
该研究纳入了70例在京都大学医院等待LT的终末期肺病患者。我们使用Kaplan-Meier曲线和Cox比例风险回归模型，研究了包括体重指数和身体成分、血清白蛋白、血清C反应蛋白（CRP）、类固醇给药、身体活动水平（通过食物频率问卷计算）等基线特征与等待期生存之间的关联。
身体活动水平≤1.2与生存率显著降低相关（1年生存率：68%对90.9%，p = 0.0089），风险比（HR）为2.24（95%置信区间（CI）1.22 - 4.19，p = 0.0001）。低白蛋白血症（HR 2.024，95% CI 1.339 - 6.009，p = 0.004）、高水平的CRP（HR 2.551，CI 1.229 - 4.892，p = 0.02）以及类固醇给药（HR 2.258，CI 1.907 - 5.032，p = 0.024）也是生存的显著预测因素。
LT等待期内身体活动水平低导致LT候选者的生存时间缩短。
