Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/35538
Title: Effect of pulmonary rehabilitation on all-cause mortality in patients with chronic respiratory disease: a retrospective cohort study in an Australian teaching hospital.
Austin Authors: Sharifi, Vahid;Brazzale, Danny J ;McDonald, Christine F ;Hill, Catherine J ;Michael, Chris;Ruehland, Warren R ;Berlowitz, David J 
Affiliation: Respiratory and Sleep Medicine
Institute for Breathing and Sleep
Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia.
Issue Date: 10-Oct-2024
Date: 2024
Publication information: BMC Pulmonary Medicine 2024-10-10; 24(1)
Abstract: Pulmonary rehabilitation (PR) is widely recommended for short-term benefits in chronic respiratory diseases, yet long-term outcomes remain uncertain. This retrospective cohort study addresses this gap, comparing 20-year mortality rates between PR participants and matched controls, and hypothesizing that the short-term benefits of PR contribute to improved long-term survival. The 20-year mortality of stable chronic respiratory patients who participated in an outpatient PR program was compared with a matched control group based on the type of lung disease. Demographic and clinical variables, and the dates of deaths, were extracted and compared between two groups with two sample t-test and chi-square tests. Kaplan-Meier plots and Cox regression analyses were employed to evaluate survival differences. Between 2000 and 2002, 238 individuals enrolled in a pulmonary rehabilitation (PR) program (58% male, mean age ± SD: 69 ± 8 years, mean FEV1% predicted ± SD: 46 ± 21%). An equal number of people with comparable lung disease were selected as controls (88% COPD, 5% ILD). Controls had lower FEV1% predicted values (mean ± SD: 39 ± 17%, P < 0.001), smoked more (mean ± SD: 48 ± 35 pack-years, P = 0.032), and no differences in age, BMI, sex, and Index of Relative Socio-economic Advantage and Disadvantage (IRSAD). Median (IQR) follow-up time was 68 months (34-123), with 371 (78%) deaths. Univariable (HR = 1.71, p < 0.001) and multivariable (HR = 1.64, p < 0.001) Cox regression found higher mortality risk in controls. Subgroup analysis for COPD replicated these findings (HR = 1.70, P < 0.001). Despite some methodological limitations, our study suggests that clinically stable patients with chronic respiratory disease who undertake PR may have lower mortality than matched controls. Retrospectively registered.
URI: https://ahro.austin.org.au/austinjspui/handle/1/35538
DOI: 10.1186/s12890-024-03319-9
ORCID: 
Journal: BMC Pulmonary Medicine
Start page: 501
PubMed URL: 39390462
ISSN: 1471-2466
Type: Journal Article
Subjects: Asthma
COPD
Chronic respiratory disease
ILD
Mortality
Pulmonary rehabilitation
Spirometry
Survival analysis
Pulmonary Disease, Chronic Obstructive/rehabilitation
Pulmonary Disease, Chronic Obstructive/mortality
Australia/epidemiology
Lung Diseases, Interstitial/rehabilitation
Lung Diseases, Interstitial/mortality
Appears in Collections:Journal articles

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