Bernabeu-Mora Roberto, Valera-Novella Elisa, Bernabeu-Serrano Elodia Teresa, Soler-Cataluña Juan José, Calle-Rubio Myriam, Medina-Mirapeix Francesc
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.
Arch Bronconeumol. 2025 Feb;61(2):90-95. doi: 10.1016/j.arbres.2024.07.026. Epub 2024 Aug 31.
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.
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.
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.
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.
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。
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。
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)。
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。