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五次重复坐立试验作为高危慢性阻塞性肺疾病患者死亡率的预测指标

Five-Repetition Sit-to-Stand Test as Predictor of Mortality in High Risk COPD Patients.

作者信息

Bernabeu-Mora Roberto, Valera-Novella Elisa, Bernabeu-Serrano Elodia Teresa, Soler-Cataluña Juan José, Calle-Rubio Myriam, Medina-Mirapeix Francesc

机构信息

Department of Pneumology, Hospital General Universitario Morales Meseguer, Murcia, Spain; Department of Internal Medicine, University of Murcia, Murcia, Spain; Research Group Fisioterapia y Discapacidad, Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain.

Department of Physical Therapy, University of Murcia, Murcia, Spain; Research Group Fisioterapia y Discapacidad, Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain.

出版信息

Arch Bronconeumol. 2025 Feb;61(2):90-95. doi: 10.1016/j.arbres.2024.07.026. Epub 2024 Aug 31.

Abstract

OBJECTIVE

To determine if adding performance on the five-repetition sit-to-stand test (5-STS) to chronic obstructive pulmonary disease (COPD) high-risk criteria, proposed by the Spanish COPD guidelines (GesEPOC), affects mortality prognosis.

METHODS

Observational study of COPD outpatients involved prospective follow-up for 5 years. Patients were classified based on 5-STS performance and risk criteria proposed by GesEPOC version 2021. Outcome measures were 5-year mortality timing and rate. Kaplan-Meier curves and univariate and multivariate Cox proportional-hazard analyses, analysis of variance, and univariate and multivariate linear and logistic regression models were used.

RESULTS

One hundred and thirty-seven patients were included. Mean age was 66±8.3 years, and 87.6% were men. Of them, 115 (83.9%) were classified as high risk, 43 (34.4%) of whom had poor performance on the 5-STS. Overall mortality at 5 years was 27% and was significantly higher in the high-risk (29.6%) compared with the low-risk (13.6%) group. Among high-risk patients, mortality at 5 years was significantly worse with poor 5-STS performance (60.5%) compared with non-poor performance (11.1%). Poor performance on the 5-STS was independently associated with increased 5-year mortality risk (HR 4.70; 95% CI: 1.96-11.27) in a model adjusted for history of heart disease and dyspnea.

CONCLUSION

Among high-risk COPD patients, those with poor performance on the 5-STS have a significantly higher mortality at 5 years than those with non-poor 5-STS performance.

摘要

目的

确定将五次重复坐立试验(5-STS)的表现纳入西班牙慢性阻塞性肺疾病(COPD)指南(GesEPOC)提出的COPD高危标准是否会影响死亡预后。

方法

对COPD门诊患者进行观察性研究,进行为期5年的前瞻性随访。根据5-STS表现和GesEPOC 2021版提出的风险标准对患者进行分类。结局指标为5年死亡率的时间和发生率。使用Kaplan-Meier曲线、单因素和多因素Cox比例风险分析、方差分析以及单因素和多因素线性和逻辑回归模型。

结果

纳入137例患者。平均年龄为66±8.3岁,87.6%为男性。其中,115例(83.9%)被分类为高危,其中43例(34.4%)在5-STS上表现不佳。5年总死亡率为27%,高危组(29.6%)显著高于低危组(13.6%)。在高危患者中,5-STS表现不佳者5年死亡率(60.5%)显著高于表现不差者(11.1%)。在调整了心脏病史和呼吸困难的模型中,5-STS表现不佳与5年死亡风险增加独立相关(风险比4.70;95%置信区间:1.96-11.27)。

结论

在高危COPD患者中,5-STS表现不佳者5年死亡率显著高于5-STS表现不差者。

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