Physical Activity Tied to Lower Risk of Mortality After COPD Hospitalization

Patients with chronic obstructive pulmonary disease (COPD) who engage in greater amounts of physical activity in the 12 months prior to hospitalization for COPD have a lower risk of death in the year following discharge compared with inactive patients, according to a new study published in ERJ Open Research.

Marilyn L. Moy, MD, and colleagues at the Veterans Affairs Boston Healthcare System, Harvard Medical School, and Kaiser Permanente Southern California, said their finding is important because rehospitalization and death rates are as high as 25% and 21%, respectively, at 1 year in COPD patients who have been hospitalized for an acute exacerbation. The ability to identify those at high risk for rehospitalization and death after hospital admission for an acute exacerbation of COPD would make it possible to target high-risk patients for treatment and intervention.

“Although physical activity level in stable COPD is associated with mortality, the relationship between physical activity and risk of death in a high-risk group of patients after an index COPD hospitalisation is unknown,” the authors wrote.

Patients were included in the study if they were hospitalized for COPD between January 1, 2011, and December 31, 2011. Physical activity was routinely assessed at outpatient visits before hospitalization, as self-reported minutes of moderate to vigorous physical activity. The self-reports were classified as inactive (73%), insufficiently active (17%), and active (10%).

Among 2370 patients (55% females; mean age, 73±11 years) there were 464 (20%) deaths in the 12 months after hospitalization. Patients who were insufficiently active or active had a 28% and 47% lower risk of death, respectively, in the 12 months after the initial COPD hospitalization compared with inactive patients. Nearly 75% of the deaths were preceded by a hospitalization for COPD or other cause, the researchers said.

Using a routine simple exercise vital sign, patients who report engaging in any level of moderate to vigorous physical activity are at lower risk of dying in the 12 months following a COPD hospitalization compared with those who are physically inactive, the authors conclude.

“While our findings suggest that physical activity level is another useful predictor of mortality, engagement in any level of moderate to vigorous physical activity and thus maintenance of a physically active lifestyle in this population could potentially buffer the physical and emotional stresses of repeated hospitalizations due to COPD or other causes.,” the authors wrote.

In addition, other lifestyle factors such as active cigarette smoking, not participating in pulmonary rehabilitation, and poor nutritional status were also found to be independent predictors of death.

“Our study emphasizes the need for continued multidisciplinary interventions to improve outcomes by promoting long-term behavior change,” the researchers concluded.