Hove, H. ten (Hester) (2019) 5-year mortality and mortality predictors in geriatric rehabilitation for Chronic Obstructive Pulmonary Disease: a 5-year follow-up study. thesis, Medicine.
Full text available on request.Abstract
Introduction: Multidisciplinary pulmonary rehabilitation (PR) is recommended by current guidelines after exacerbations of Chronic Obstructive Pulmonary Disease (COPD). However, studies on mortality after PR are scarce, especially for late-stage COPD patients. This study provides missing mortality data, for frail (elderly) COPD patients after participating in an extensive post-acute geriatric rehabilitation program: the GR-COPD program. Furthermore, factors related to increased mortality were analysed. Methods: All patients participating in the GR-COPD program between May 2009 and January 2011 were included in this retrospective cohort study. We assessed several patient and disease characteristics including lung function, psychosocial and nutritional status, presence of comorbidity, uBode-index scores, improvement in health status; and mortality. Patient and disease characteristics were analysed according to survival status and potential determinants of mortality were evaluated using univariate Cox-regression analyses. Results: The cohort consisted of 61 patients (51% male), with advanced COPD and frequent comorbidities. Patients had a mean ±SD age of 69±9,7 years and a mean FEV1%predicted of 32%±9.9. The 1, 3, and 5-year mortality was respectively 14.8%, 54.1%, and 68.9%. Both the uBODE-index (HR 1.132, p=0.008) and long-term use of oral corticosteroids (HR 2.476, p=0.005) were associated with mortality. Higher age was not related to increased mortality. In contrast, there was a tendency for an increased mortality risk in tertile I (≤63 years) compared to tertile II (64-74 years) (HR 0.491, p=0.050). Conclusion: 5-year mortality of frail (elderly) patients with advanced COPD, who participated in the GR-COPD program was high. Long-term use of oral corticosteroids and higher uBODE-index scores were identified as risk factors for mortality. Higher age was not related to mortality.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Supervisor: and Groenewegen, Dr. K. H. and 2nd supervisor: and Dam van Isselt, Dr. E.F. van and Collaboration between the pulmonary department of the Deven |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:42 |
| Last Modified: | 25 Jun 2020 10:42 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/321 |
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