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Influence of changes in physical activity on frequency of hospitalization in chronic obstructive pulmonary disease

Authors

  • Cristóbal Esteban,

    Corresponding author
    1. Respiratory Service, Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain
    2. Network of Research on Health Services and Chronic Diseases (REDISSEC), Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain
    • Correspondence: Cristóbal Esteban, Servicio de Neumología, Hospital de Galdakao-Usansolo, Barrio Labeaga s/n. 48960, Galdakao, Bizkaia, Spain. Email: cristobal.est@gmail.com

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  • Inmaculada Arostegui,

    1. Research Unit—CIBER Epidemiology and Public Health (CIBERESP), Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain
    2. Department of Applied Mathematics and Statistics and Operational Research, Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain
    3. Network of Research on Health Services and Chronic Diseases (REDISSEC), Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain
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  • Myriam Aburto,

    1. Respiratory Service, Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain
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  • Javier Moraza,

    1. Respiratory Service, Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain
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  • José M. Quintana,

    1. Research Unit—CIBER Epidemiology and Public Health (CIBERESP), Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain
    2. Network of Research on Health Services and Chronic Diseases (REDISSEC), Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain
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  • Susana Aizpiri,

    1. Respiratory Service, Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain
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  • Luis V. Basualdo,

    1. Respiratory Service, Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain
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  • Alberto Capelastegui

    1. Respiratory Service, Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain
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  • Conflict of interest: BJP has acted as a paid consultant to Faust Pharmaceuticals Inc. and has received funding for research carried out in this work.
  • (Associate Editor: Shu Hashimoto).

Abstract

Background and objective

To evaluate whether changes in regular physical activity (PA) in patients with chronic obstructive pulmonary disease (COPD) affect the rate of hospitalizations for COPD exacerbation (eCOPD).

Methods

Five hundred forty-three ambulatory clinic patients being treated for COPD were prospectively identified. PA was self-reported by patients, and the level was established by the distance they walked (km/day) at least 3 days per week. Hospitalizations were recorded from hospital databases. All patients with at least a 2-year follow-up after enrolment were included in the analysis. The response variable was the number of hospitalizations for eCOPD within the 3-year period from 2 to 5 years after study enrolment.

Results

Three hundred ninety-one survivors were studied. Mean forced expiratory volume in 1 s was 52% (±14%) of the predicted value. Patients who maintained a lower level of PA had an increased rate of hospitalization (odds ratio 1.901; 95% confidence interval 1.090–3.317). After having had the highest level of PA, those patients who decreased their PA in the follow-up showed an increasing rate of hospitalizations (odds ratio 2.134; 95% confidence interval 1.146–3.977).

Conclusions

Patients with COPD with a low level of PA or who reduced their PA over time were more likely to experience a significant increase in the rate of hospitalization for eCOPD. Changes to a higher level of PA or maintaining a moderate or high level of PA over time, with a low intensity activity such as walking for at least 3–6 km/day, could reduce the rate of hospitalizations for eCOPD.

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