Nopp Stephan, Klok Frederikus A, Moik Florian, Petrovic Milos, Derka Irmgard, Ay Cihan, Zwick Ralf Harun
Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, 1090 Vienna, Austria.
Department of Thrombosis and Hemostasis, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands.
J Clin Med. 2020 Jun 10;9(6):1811. doi: 10.3390/jcm9061811.
Patients with pulmonary embolism (PE) may suffer from long-term consequences, including decreased functional capacity. Data on pulmonary rehabilitation (PR) in patients with PE are scarce, and no data on outpatient PR are available so far. We analyzed data of 22 PE patients who attended outpatient PR due to exertional dyspnea. Patients underwent a multi-professional 6-week PR program. The primary outcome was change in 6-min walk test (6MWT). Secondary outcomes included changes in strength and endurance tests. To assess long-term benefits, follow-up was performed a median of 39 months after PR. Patients started PR a median of 19 weeks after the acute PE event. Their median age was 47.5 years, 33% were women and all presented with NYHA (New York Heart Association) class II and higher. After PR, patients showed significant and clinically relevant improvements in 6MWT (mean difference: 49.4 m [95% CI 32.0-66.8]). Similarly, patients increased performance in maximum strength, endurance and inspiratory muscle strength. At long-term follow-up, 78% of patients reported improved health. We observed significant improvements in exercise capacity in PE patients undergoing outpatient PR. The majority of patients also reported a long-term improvement in health status. Prospective studies are needed to identify patients who would benefit most from structured PR.
肺栓塞(PE)患者可能会遭受长期后果,包括功能能力下降。关于PE患者肺康复(PR)的数据很少,目前尚无关于门诊PR的数据。我们分析了22例因运动性呼吸困难而参加门诊PR的PE患者的数据。患者接受了为期6周的多专业PR计划。主要结局是6分钟步行试验(6MWT)的变化。次要结局包括力量和耐力测试的变化。为了评估长期益处,在PR后中位39个月进行了随访。患者在急性PE事件后中位19周开始PR。他们的中位年龄为47.5岁,33%为女性,均表现为纽约心脏协会(NYHA)II级及以上。PR后,患者在6MWT方面显示出显著且具有临床意义的改善(平均差异:49.4米[95%CI 32.0-66.8])。同样,患者在最大力量、耐力和吸气肌力量方面的表现有所提高。在长期随访中,78%的患者报告健康状况有所改善。我们观察到接受门诊PR的PE患者的运动能力有显著改善。大多数患者还报告健康状况有长期改善。需要进行前瞻性研究以确定哪些患者将从结构化PR中获益最大。