title: Determinants of change in physical activity during moderate-to-severe COPD exacerbation.
abstract: BACKGROUND
  Data are scarce on patient physical activity (PA) level during exacerbations of chronic obstructive pulmonary disease (eCOPD). The objective of the study was to evaluate the level and determinants of change in PA during an eCOPD.
  
  
  METHODS
  We conducted a prospective cohort study with recruitment from emergency departments (EDs) of 16 participating hospitals from June 2008 to September 2010. Data were recorded on socioeconomic characteristics, dyspnea, forced expiratory volume in 1 second (FEV1%), comorbidities, health-related quality of life, factors related to exacerbation, and PA in a stable clinical condition and during the eCOPD episode.
  
  
  RESULTS
  We evaluated 2,487 patients. Common factors related to the change in PA during hospital admission or 7 days after discharge to home from the ED were lower PA at baseline and during the first 24 hours after the index evaluation. Age, quality of life, living alone, length of hospital stay, and use of anticholinergic or systemic corticosteroids in treating the exacerbation were associated with the change in PA among hospitalized patients. Predictors of change among patients not admitted to hospital were baseline FEV1% and dyspnea at rest on ED arrival.
  
  
  CONCLUSIONS
  Among the patients evaluated in an ED for an eCOPD, the level and change in PA was markedly variable. Factors associated with exacerbation (PA 24 hours after admission, medication during admission, and length of hospital stay) and variables reflecting patients' stable clinical condition (low level of PA, age, quality of life, FEV1%) are predictors of the change in PA during a moderate-to-severe eCOPD.
authors.affiliation: Respiratory Department, Hospital Galdakao-Usansolo, Bizkaia, Spain; Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Galdakao, Spain.
authors.forename: Cristóbal
authors.initials: C
authors.lastname: Esteban
authors.affiliation: Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Galdakao, Spain; Research Unit, Hospital Galdakao-Usansolo, Bizkaia, Spain.
authors.forename: José M
authors.initials: JM
authors.lastname: Quintana
authors.affiliation: Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Galdakao, Spain; Research Unit, Hospital Galdakao-Usansolo, Bizkaia, Spain.
authors.forename: Susana
authors.initials: S
authors.lastname: Garcia-Gutierrez
authors.affiliation: Research Unit, Hospital Galdakao-Usansolo, Bizkaia, Spain.
authors.forename: Ane
authors.initials: A
authors.lastname: Anton-Ladislao
authors.affiliation: Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Galdakao, Spain; Research Unit, Hospital Galdakao-Usansolo, Bizkaia, Spain.
authors.forename: Nerea
authors.initials: N
authors.lastname: Gonzalez
authors.affiliation: Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Galdakao, Spain; Unit of Clinical Epidemiology, Corporacio Parc Tauli, Barcelona, Spain.
authors.forename: Marisa
authors.initials: M
authors.lastname: Baré
authors.affiliation: Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Galdakao, Spain; Health Department, Madrid, Spain.
authors.forename: Nerea
authors.initials: N
authors.lastname: Fernández de Larrea
authors.affiliation: Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Galdakao, Spain; Research Unit, Hospital Costa del Sol, Mabella, Málaga, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Rivas-Ruiz
mesh_terms: D000368:Aged; D018680:Cholinergic Antagonists / Q000627:therapeutic use*; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D011379:Prognosis; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology; D000067251:Symptom Flare Up
chemical_list: D018680:Cholinergic Antagonists; D005938:Glucocorticoids
keywords: COPD exacerbations; physical activity; prospective cohort study