Chest
Original ResearchCOPDPhysical Activity Is the Strongest Predictor of All-Cause Mortality in Patients With COPD: A Prospective Cohort Study
Section snippets
Study Population
In 2006, 170 stable outpatients with COPD (128 men, 42 women) with GOLD (Global Initiative for Chronic Obstructive Lung Disease) stages I (n = 34), II (n = 57), III (n = 43), and IV (n = 36) were investigated at the Pulmonary Research Institute at Hospital Grosshansdorf, Grosshansdorf, Germany. The patients were enrolled in a prospective observational study to investigate the role of extrapulmonary effects of COPD for disease severity and disease progression. The objective measurement of
Baseline Characteristics and Survival
Patient characteristics at baseline are shown in Table 1. Twenty-six (15.4%) patients died over a median follow-up of 48 months (range, 10-53 months). There were significant differences between survivors and nonsurvivors in FEV1, inspiratory to total lung capacity ratio (IC/TLC), PAL, step counts per day, 6-min walk distance, BMI, fat-free mass index, Tei index, NT-pro-BNP, ABI, adiponectin level, degree of dyspnea, SGRQ total score and activity subdomain, and mortality risk scores. Patient
Discussion
The main finding of our study is that objectively measured physical activity is the best predictor of all-cause mortality in patients with COPD. In addition, higher levels of adiponectin and an impaired vascular status provide independent prognostic information in our cohort.
Acknowledgments
Author contributions: Dr Waschki had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Dr Waschki: contributed to the data collection, statistical analysis, and data interpretation and wrote the first draft of the manuscript.
Dr Kirsten: contributed to the data collection and interpretation and revision of the manuscript.
Dr Holz: contributed to the data collection and interpretation and revision of the
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Drs Watz and Magnussen contributed equally to this work.
Funding/Support: This study was supported by Deutsche Rentenversicherung Nord. Some baseline measurements for cross-sectional analyses were supported by an unrestricted research grant from AstraZeneca Germany.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).