Key result
Upper extremity function testing predicts adverse outcomes in hospitalized COPD patients with ~78% accuracy.
Why the study?
The 6-minute walk distance test predicts adverse outcomes in COPD but is often not feasible for frail patients, creating a need for an alternative objective, quick, and simple assessment of functional capacity.
Does an upper extremity function test accurately predict adverse outcomes in older adults hospitalized for COPD exacerbation?
Observational (n=192)
Does an upper extremity function test accurately predict adverse outcomes in older adults hospitalized for COPD exacerbation?
An upper extremity sensor-based test offers a feasible and accurate alternative to traditional functional assessments for predicting adverse outcomes in frail patients hospitalized with COPD exacerbation.
Background: Decisions about the intensity of treatment for patients with COPD are influenced by the ability to predict upcoming adverse outcomes after treatment. The 6-minute walk distance test is commonly used to assess functional capacity in patients with COPD for predicting adverse outcomes. Although the 6-minute walk distance showed adequate reliability and validity, it is often not feasible for frail patients. Therefore, an alternative objective, quick, and simple approach for assessing functional capacity in COPD is needed. Research Question: Is an upper extremity test an accurate and feasible method for assessing fnctional capacity individuals with COPD? Study Design and Methods: We previously developed and validated an upper extremity function (UEF) test, incorporating motor function kinematics and muscle force measures for assessing functional capacity in COPD. In this study, with the goal of longitudinal evaluation of the UEF test for predicting adverse outcomes, we recruited 192 hospitalized older adults that were admitted due to COPD exacerbation. In-hospital (ie, mortality, excessive length of stay, complications) and longitudinal 90-day (ie, acute COPD exacerbation, mortality, readmission) outcomes were recorded. We developed a risk stratification model using elastic net regularization for selecting optimum feature sets (kinematics and muscle model parameters) in combination with support vector machine to predict adverse outcomes. Results: Results from 10-fold cross-validation for model prediction showed, on average, accuracy of 78% in predicting in-hospital outcomes and accuracy of 76% in predicting 30- to 90-day longitudinal outcomes. Interpretation: Current findings suggested that the UEF test may provide an efficient method for risk stratifying older adults with COPD, with accuracy higher than other available tools within our recorded data set (ie, clinical frailty score and COPD assessment test with accuracies < 61%).
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Asghari et al. (2024) conducted an observational in COPD exacerbation (n=192). Upper extremity function (UEF) test vs. Clinical frailty score and COPD assessment test was evaluated on In-hospital outcomes (mortality, excessive length of stay, complications) and longitudinal 90-day outcomes (acute COPD exacerbation, mortality, readmission). An upper extremity function test predicted in-hospital and 90-day adverse outcomes in hospitalized COPD patients with 78% and 76% accuracy, respectively.
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