Pulmonary Rehabilitation in Idiopathic Pulmonary Fibrosis and COPD: A Propensity-Matched Real-World Study.

Autor:	Nolan CM; Harefield Respiratory Research Group, Royal Brompton and Harefield Clinical Group, Guy's and St. Thomas' NHS Foundation Trust, London, England; National Heart and Lung Institute, Imperial College London, London, England; Brunel University London, College of Health Medicine and Life Sciences, London, England. Electronic address: c.nolan@rbht.nhs.uk., Polgar O; Harefield Respiratory Research Group, Royal Brompton and Harefield Clinical Group, Guy's and St. Thomas' NHS Foundation Trust, London, England., Schofield SJ; National Heart and Lung Institute, Imperial College London, London, England., Patel S; Harefield Respiratory Research Group, Royal Brompton and Harefield Clinical Group, Guy's and St. Thomas' NHS Foundation Trust, London, England; National Heart and Lung Institute, Imperial College London, London, England., Barker RE; Harefield Respiratory Research Group, Royal Brompton and Harefield Clinical Group, Guy's and St. Thomas' NHS Foundation Trust, London, England; National Heart and Lung Institute, Imperial College London, London, England; Wessex Academic Health Science Network, Southampton, England., Walsh JA; Harefield Respiratory Research Group, Royal Brompton and Harefield Clinical Group, Guy's and St. Thomas' NHS Foundation Trust, London, England., Ingram KA; Harefield Pulmonary Rehabilitation Unit, Royal Brompton and Harefield Clinical Group, Guy's and St. Thomas' NHS Foundation Trust, London, England., George PM; Interstitial Lung Disease Unit, Royal Brompton and Harefield Clinical Group, Guy's and St. Thomas' NHS Foundation Trust, London, England; National Heart and Lung Institute, Imperial College London, London, England., Molyneaux PL; Interstitial Lung Disease Unit, Royal Brompton and Harefield Clinical Group, Guy's and St. Thomas' NHS Foundation Trust, London, England; National Heart and Lung Institute, Imperial College London, London, England., Maher TM; Interstitial Lung Disease Unit, Royal Brompton and Harefield Clinical Group, Guy's and St. Thomas' NHS Foundation Trust, London, England; National Heart and Lung Institute, Imperial College London, London, England; Keck School of Medicine, University of Southern California, Los Angeles, CA., Man WD; Harefield Respiratory Research Group, Royal Brompton and Harefield Clinical Group, Guy's and St. Thomas' NHS Foundation Trust, London, England; Harefield Pulmonary Rehabilitation Unit, Royal Brompton and Harefield Clinical Group, Guy's and St. Thomas' NHS Foundation Trust, London, England; National Heart and Lung Institute, Imperial College London, London, England.
Jazyk:	angličtina
Zdroj:	Chest [Chest] 2022 Mar; Vol. 161 (3), pp. 728-737. Date of Electronic Publication: 2021 Oct 23.
DOI:	10.1016/j.chest.2021.10.021
Abstrakt:	Background: The adherence to and clinical efficacy of pulmonary rehabilitation in idiopathic pulmonary fibrosis (IPF), particularly in comparison with COPD, remains uncertain. The objectives of this real-world study were to compare the responses of patients with IPF with a matched group of patients with COPD undergoing the same supervised, outpatient pulmonary rehabilitation program and to determine whether pulmonary rehabilitation is associated with survival in IPF. Research Question: Do people with IPF improve to the same extent with pulmonary rehabilitation as a matched group of individuals with COPD, and are noncompletion of or nonresponse to pulmonary rehabilitation, or both, associated with 1-year all-cause mortality in IPF? Study Design and Methods: Using propensity score matching, 163 patients with IPF were matched 1:1 with a control group of 163 patients with COPD referred for pulmonary rehabilitation. We compared between-group pulmonary rehabilitation completion rates and response. Survival status in the IPF cohort was recorded over 1 year after pulmonary rehabilitation discharge. Cox proportional hazards regression explored the association between pulmonary rehabilitation status and all-cause mortality. Results: Similar pulmonary rehabilitation completion rates (IPF, 69%; COPD, 63%; P = .24) and improvements in exercise response were observed in both groups with no significant mean between-group differences in incremental shuttle walk test (ISWT) change (mean, 2 m [95% CI, -18 to 22 m]). Pulmonary rehabilitation noncompletion (hazard ratio [HR], 5.62 [95% CI, 2.24-14.08]) and nonresponse (HR, 3.91 [95% CI, 1.54-9.93]) were associated independently with increased 1-year all-cause mortality in IPF. Interpretation: This real-word study demonstrated that patients with IPF have similar completion rates and magnitude of response to pulmonary rehabilitation compared with a matched group of patients with COPD. In IPF, noncompletion of and nonresponse to pulmonary rehabilitation were associated with increased all-cause mortality. These data reinforce the benefits of pulmonary rehabilitation in patients with IPF. (Copyright © 2021 The Author(s). Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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