Lopez Pedro, Fitzgerald Deirdre B, McVeigh Joanne A, Badiei Arash, Muruganandan Sanjeevan, Newton Robert U, Straker Leon, Lee Yun Chor Gary, Peddle-McIntyre Carolyn J
Pleural Medicine Unit, Institute for Respiratory Health, Perth, Australia.
Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia.
ERJ Open Res. 2023 Sep 25;9(5). doi: 10.1183/23120541.00209-2023. eCollection 2023 Sep.
Little is known about activity behaviours and quality of life (QoL) of patients with parapneumonic pleural effusions (PPE) after hospital discharge. This study is a secondary analysis of a randomised trial (dexamethasone placebo) for hospitalised patients with PPE. We: 1) described the patients' activity behaviour patterns and QoL measured at discharge and at 30 days post-discharge; and 2) examined the association between activity behaviours and QoL scores.
Activity behaviour (7-day accelerometry; Actigraph GT3X+) and QoL (Medical Outcomes Study Short-Form 36) were assessed. Repeated measures analysis of covariance controlling for baseline values and a series of linear regression models were undertaken.
36 out of 53 eligible participants completed accelerometry assessments. Despite modest increases in light physical activity (+7.5%) and some domains of QoL (>2 points) from discharge to 30 days post-discharge, patients had persistently high levels of sedentary behaviour (>65% of waking wear time) and poor QoL (≤50 out of 100 points) irrespective of treatment group (p=0.135-0.903). Increasing moderate-to-vigorous physical activity was associated with higher scores on most QoL domains (p=0.006-0.037). Linear regression indicates that a clinically important difference of 5 points in physical composite QoL score can be achieved by reallocating 16.1 min·day of sedentary time to moderate-to-vigorous physical activity.
Patients with PPE had low levels of physical activity and QoL at discharge and 30 days post-discharge irrespective of treatment. Moderate-to-vigorous physical activity participation was associated with higher QoL scores. Increasing moderate-to-vigorous physical activity following discharge from the hospital may be associated with improvements in QoL.
关于肺炎旁胸腔积液（PPE）患者出院后的活动行为和生活质量（QoL），人们了解甚少。本研究是一项针对住院PPE患者的随机试验（地塞米松与安慰剂对照）的二次分析。我们：1）描述了患者出院时及出院后30天测量的活动行为模式和生活质量；2）研究了活动行为与生活质量评分之间的关联。
评估活动行为（7天加速度计测量；Actigraph GT3X+）和生活质量（医学结局研究简表36）。进行了控制基线值的重复测量协方差分析和一系列线性回归模型分析。
53名符合条件的参与者中有36名完成了加速度计评估。尽管从出院到出院后30天，轻度体力活动略有增加（+7.5%），生活质量的某些领域也有所改善（>2分），但无论治疗组如何，患者久坐行为水平持续较高（清醒佩戴时间的>65%），生活质量较差（≤100分中的50分）（p=0.135 - 0.903）。增加中度至剧烈体力活动与大多数生活质量领域的更高评分相关（p=0.006 - 0.037）。线性回归表明，通过将16.1分钟/天的久坐时间重新分配为中度至剧烈体力活动，身体综合生活质量评分可实现5分的临床显著差异。
无论治疗如何，PPE患者出院时及出院后30天的体力活动水平和生活质量都较低。参与中度至剧烈体力活动与更高的生活质量评分相关。出院后增加中度至剧烈体力活动可能与生活质量改善相关。
