Mortality predictive factors in COPD patients after a pulmonary rehabilitation programme - a 3 years study

Chronic obstructive pulmonary disease (COPD) is a high mortality disease and projected to become the third worldwide cause of death by 2030. The aim of our study was to determine clinical and functional predictors of 3 year mortality in COPD patients that have completed a pulmonary rehabilitation (PR) programme. We also analyzed associated factors with early (1 year) and late mortality (second and third year). A retrospective analysis was performed on data from patients admitted to respiratory failure daily-hospital unit from January 2008 to December, 2010. 183 patients completed a PR programme. Of these, 93 patients had COPD. Population was characterized based on sociodemographic factors, body mass index, smoking habit, lung function tests, respiratory insufficiency, comorbidities, bacterial colonization, mMRC dyspnea index, 6MWT, mechanical ventilation, non-invasive ventilation, long term oxygen therapy, hospital admissions three years prior and after the programme and mortality. Our sample had 78 male and 15 female patients. The mean age was 68.6 ± 8.8 years. After PR programme, hospital admissions number was lower, but not significant (p: 0.170). Respiratory insufficiency (p: 0.008), non-invasive ventilation (p: 0.001), lung cancer (p: 0.001), an inferior distance in the 6MWT (p < 0.005) and higher number of admissions were all associated with a higher mortality rate. Analysis of patients who died showed us that atrial fibrillation (AF) was the only comorbity associated with early mortality (1 year) (p: 0.039), although AF was not a factor in general mortality.