Division of Experimental Medicine and Immunotherapeutics, Department of Medicine, University of Cambridge, Cambridge, England, United Kingdom.
British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, England, United Kingdom.
PLoS One. 2020 Feb 10;15(2):e0228940. doi: 10.1371/journal.pone.0228940. eCollection 2020.
In chronic obstructive pulmonary disease (COPD), acute exacerbation of COPD requiring hospital admission is associated with mortality and healthcare costs. The ERICA study assessed multiple clinical measures in people with COPD, including the short physical performance battery (SPPB), a simple test of physical function with 3 components (gait speed, balance and sit-to-stand). We tested the hypothesis that SPPB score would relate to risk of hospital admissions and length of hospital stay. Data were analysed from 714 of the total 729 participants (434 men and 280 women) with COPD. Data from this prospective observational longitudinal study were obtained from 4 secondary and 1 tertiary centres from England, Scotland, and Wales. The main outcome measures were to estimate the risk of hospitalisation with acute exacerbation of COPD (AECOPD and length of hospital stay derived from hospital episode statistics (HES). In total, 291 of 714 individuals experienced 762 hospitalised AECOPD during five-year follow up. Poorer performance of SPPB was associated with both higher rate (IRR 1.08 per 1 point decrease, 95% CI 1.01 to 1.14) and increased length of stay (IRR 1.18 per 1 point decrease, 95% CI 1.10 to 1.27) for hospitalised AECOPD. For the individual sit-to-stand component of the SPPB, the association was even stronger (IRR 1.14, 95% CI 1.02 to 1.26 for rate and IRR 1.32, 95% CI 1.16 to 1.49 for length of stay for hospitalised AECOPD). The SPPB, and in particular the sit-to-stand component can both evaluate the risk of H-AECOPD and length of hospital stay in COPD. The SPPB can aid in clinical decision making and when prioritising healthcare resources.
在慢性阻塞性肺疾病（COPD）中，需要住院治疗的 COPD 急性加重与死亡率和医疗保健成本相关。ERICA 研究评估了 COPD 患者的多项临床指标，包括简短体能测试（SPPB），这是一种具有 3 个组成部分（步态速度、平衡和坐站）的简单身体功能测试。我们检验了 SPPB 评分与住院风险和住院时间的相关性假设。数据分析来自 729 名 COPD 患者中的 714 名（434 名男性和 280 名女性）。这项前瞻性观察性纵向研究的数据来自英格兰、苏格兰和威尔士的 4 家二级和 1 家三级中心。主要结局测量指标是估计 COPD 急性加重（AECOPD）的住院风险和住院时间（根据医院发病统计数据（HES）得出）。在 5 年随访期间，714 人中共有 291 人经历了 762 例住院 AECOPD。SPPB 表现越差，住院 AECOPD 的发生率越高（IRR 每降低 1 分，1.08；95%CI 1.01 至 1.14），住院时间越长（IRR 每降低 1 分，1.18；95%CI 1.10 至 1.27）。对于 SPPB 的个体坐站组成部分，相关性甚至更强（IRR 1.14，95%CI 1.02 至 1.26 用于发病率，IRR 1.32，95%CI 1.16 至 1.49 用于住院 AECOPD 的住院时间）。SPPB，特别是坐站成分，均可评估 COPD 患者的 H-AECOPD 风险和住院时间。SPPB 可用于临床决策和优先考虑医疗保健资源。
