Effects of respiratory rehabilitation in patients with chronic obstructive pulmonary disease and analysis of prognostic risk factors:a retrospective study
10.3969/j.issn.1001-1242.2024.11.003
- VernacularTitle:呼吸康复对慢性阻塞性肺疾病患者的疗效及影响预后的危险因素分析:回顾性研究
- Author:
Shixian YE
1
;
Dongxing ZHAO
;
Guansheng SU
Author Information
1. 广州医科大学附属第一医院,广州呼吸健康研究院,呼吸疾病国家重点实验室,国家呼吸系统疾病临床医学研究中心,广州市,510120
- Keywords:
respiratory rehabilitation;
chronic obstructive pulmonary disease;
effect;
prognosis;
risk factors
- From:
Chinese Journal of Rehabilitation Medicine
2024;39(11):1581-1587
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the one year therapeutic effect of respiratory rehabilitation in patients with chronic ob-structive pulmonary disease(COPD)and identify prognostic risk factors. Method:COPD patients,hospitalized in the First Affiliated Hospital of Guangzhou Medical University from January 2017 to March 2019,were retrospectively analyzed.A total of 418 target patients,enrolled by 1∶1 propensity score matching,were divided into respiratory rehabilitation group and conventional treatment group according to whether they had received respiratory rehabilitation therapy.Among them,209 cases in respirato-ry rehabilitation group and 209 cases in conventional treatment group were compared one year after discharge.According to the occurrence of adverse prognostic events(death or aggravated hospitalization),the patients were divided into favorable prognosis group and bad prognosis group.According to the survival time＞1 year and＜1 year,the patients were divided into survival group and death group.x2 test was used for univariate analysis,and multivariate logistic regression model and multivariate cox proportional hazards regression model were used for multivariate analysis. Result:One year after discharge,respiratory rehabilitation group had fewer exacerbation hospitalizations than conventional treatment group(0.89±1.21 vs.1.23±1.18,P=0.008),fewer annual exacerbation hospitalizations(43.5％vs.61.7％,P＜0.001)and fewer annual frequent exacerbation hospitalizations(16.7％vs.28.2％,P=0.006),but no significant difference in the annual mortality between two groups(15.3％vs 13.4％,P＞0.05).There were significant differences between the poor prognosis group and the favorable prognosis group in respi-ratory rehabilitation therapy,history of aggravated hospitalization in the previous year,arterial blood carbon di-oxide level and bicarbonate level(P＜0.05).Arterial blood carbon dioxide level and venous blood hemoglobin level in the death group were significantly different from those in the survival group(P＜0.05).Multivariate lo-gistic regression analysis showed that the history of exacerbation hospitalization,no respiratory rehabilitation in the previous year,anemia and hypercapnia were independent risk factors for poor prognosis one year after dis-charge(P＜0.05).Multivariate cox proportional hazards regression analysis showed that anemia and hypercapnia were independent risk factors for mortality one year after discharge(P＜0.05). Conclusion:Respiratory rehabilitation therapy extended from early hospitalization to discharge effectively re-duced the composite risk of death or re-exacerbation of hospitalization in COPD patients one year after dis-charge,which is worthy of promotion.Anemia and hypercapnia were risk factors for death one year after dis-charge,and history of previous exacerbation hospitalization was a risk factor for death or re-exacerbation hospi-talization after one year discharge.
