2026-04-14T05:02:10Zhttps://recercat.cat/oai/requestoai:recercat.cat:10256/170012024-06-14T10:20:36Zcom_2072_452955com_2072_2054col_2072_453076
RECERCAT
author
Medina Mirapeix, Francesc
author
Bernabeu Mora, Roberto
author
García Guillamón, Gloria
author
Valera Novella, Elisa
author
Gacto Sánchez, Mariano
author
García Vidal, José A.
2024-06-14T10:20:36Z
2024-06-14T10:20:36Z
2016-06-14
http://hdl.handle.net/10256/17001
Hospitalization for acute exacerbations (AE) of chronic obstructive pulmonary disease
(COPD) is common, but little is known about the impact of hospitalization on the development
of disability. The purpose of this study was to determine the rate and time course of
functional changes 3 months after hospital discharge for AE-COPD compared with baseline
levels 2 weeks before admission, and to identify predictors of functional decline.
Methods
This was a prospective study including 103 patients (age mean, 71 years; standard deviation,
9.1 years) who were hospitalized with AE-COPD. Number of dependencies in Activities
of Daily Living (ADLs) was measured at the preadmission baseline and at weeks 6 and 12
after discharge. Patterns of improvement, no change, and decline were defined over 3 consecutive
intervals (baseline and weeks 6 and 12). Trajectories grouped patients with similar
time courses of disability. Recovery was defined as returning to baseline function after functional
decline. Univariate and multivariate multiple logistic regression was used to determine
predictors of functional decline after week 12.
Results
Six trajectories of functional changes were found. From baseline to 12 weeks, 50% of
patients continued to have the same function whereas 31% experienced functional decline
after 6 weeks; 16.7% recovered over subsequent weeks. At week 12, as a consequence of
all trajectories, 38% of patients showed functional declines compared with baseline function,
57% had not declined, and 6 improved. Length of stay (odds ratio [OR] = 1.12;95% [confidence interval] CI 1.03–1.22), dyspnea (OR = 1.85; 95% CI 1.05–3.26), and frailty
(OR = 3.97; 95% CI 1.13–13.92) were independent predictors of functional decline after 12
weeks.
Conclusions
Hospitalization for AE-COPD is a risk factor for the progression of disability. More than one
third of patients hospitalized for AE-COPD declined during the 12 weeks following discharge,
with most of this decline occurring by week 6
Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess
Pulmons -- Malalties
Lungs -- Diseases
Patterns, Trajectories, and Predictors of Functional Decline after Hospitalization for Acute Exacerbations in Men with Moderate to Severe Chronic Obstructive Pulmonary Disease: A Longitudinal Study
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion peer-reviewed