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In an observational study on severe acute exacerbations of chronic obstructive pulmonary disease (AECOPD) patients, recovery post-discharge showed improvements in various metrics, but those facing readmission or mortality demonstrated impaired functional test scores during hospital discharge.

The following is a summary of “Physical status, symptoms and health-related quality of life during a severe exacerbation of COPD: Recovery and discriminative capacity for future events,” published in the DECEMBER 2023 issue of Pulmonology by Quadflieg, et al.

For a study, researchers sought to comprehensively evaluate three primary objectives concerning patients who experienced severe acute exacerbations of chronic obstructive pulmonary disease (AECOPD): assess the recovery trajectory concerning muscle strength, functional capacity, symptoms, and health-related quality of life (HRQOL) post-severe AECOPD, compare these recovery metrics with matched patients who have stable COPD (SCOPD) and determine whether evaluations conducted at hospital discharge could effectively predict a patient’s risk for future exacerbation-related readmissions or mortality.

In the observational study, patients experiencing AECOPD were evaluated during their hospital discharge (T1) and subsequently one-month post-discharge (T2). Conversely, patients with SCOPD underwent a singular assessment. Various metrics were gauged across both groups, including but not limited to quadriceps force, handgrip strength, the short physical performance battery (SPPB), 6-minute walk distance (6 MWD), COPD assessment test (CAT), London chest activity of daily living (LCADL), and several other health and activity-related parameters. Furthermore, exacerbation-related readmission rates and mortality data were meticulously collected over six months and one year.

Upon analysis of 44 matched pairs of patients with AECOPD and SCOPD, a noticeable recovery was observed in various metrics at T2 for the AECOPD group, including improvements in SPPB total score, 6 MWD, CAT score, and LCADL score. However, the AECOPD cohort still exhibited inferior LCADL scores compared to their SCOPD counterparts at T2. Intriguingly, patients from the AECOPD group who faced readmission or mortality demonstrated notably impaired functional test scores during their hospital discharge (T1) assessment.

Post-severe AECOPD patients showcased substantial improvements in functional capacity and HRQOL one month post-discharge, albeit with certain deficits in activities of daily living (ADL) performance relative to those with SCOPD. Critically, patients from the AECOPD group who faced readmission or mortality exhibited pronouncedly diminished scores in functional assessments during their hospital discharge phase, underscoring the potential prognostic value of these evaluations.

Source: resmedjournal.com/article/S0954-6111(23)00325-6/fulltext