Functional status and survival following pulmonary rehabilitation.
BACKGROUND
Functional exercise capacity has been shown to be a strong predictor of survival following pulmonary rehabilitation. This study evaluated whether questionnaire-rated functional status is also predictive of survival.


METHODS
Following pulmonary rehabilitation, patients with advanced chronic lung disease were evaluated for survival, 6-min walk distance, and questionnaire-rated functional status. The latter was measured using the pulmonary functional status scale, which has subscores of functional activities, psychological status, and dyspnea. Information on survival was available on 149 patients.


RESULTS
The mean age was 69 years, and 45% of patients were male. Eighty-nine percent had a diagnosis of COPD, and their FEV(1) was 37+/-18% of predicted. Ninety-one (61%) were married. The 3-year survival for the group was 85%. Age, gender, body mass index, and primary diagnosis were not related to survival. Variables strongly associated with increased survival following pulmonary rehabilitation included a higher postrehabilitation Functional Activities score, a longer postrehabilitation 6-min walk distance, and being married (vs widowed, single, or divorced). Disease severity variables associated with survival included an initial referral to outpatient pulmonary rehabilitation, no supplemental oxygen requirement, and a higher percent-predicted FEV(1).


CONCLUSIONS
Indicators of functional status are strong predictors of survival in patients with advanced lung disease.
Bowen
J B
JB
Hospital for Special Care, New Britain, CT 06053, USA. bowenj@hfsc.org
Votto
J J
JJ
Thrall
R S
RS
Haggerty
M C
MC
Stockdale-Woolley
R
R
Bandyopadhyay
T
T
ZuWallack
R L
RL
D000368:Aged; D015992:Body Mass Index; D003237:Connecticut / Q000453:epidemiology; D005080:Exercise Test; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000401:mortality / Q000503:physiopathology / Q000534:rehabilitation*; D008297:Male; D011379:Prognosis; D016016:Proportional Hazards Models; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D015996:Survival Rate