RATIONALE: The 2011 combined Global Initiative for Chronic Obstructive Lung Disease (GOLD) assessment incorporates symptoms, exacerbation history, and spirometry in discriminating risk of exacerbations in patients with chronic obstructive pulmonary disease (COPD). Six-minute-walk distance (6MWD) and accelerometry also have been used to assess disease severity in COPD. The association between these measures and the risks of hospitalization and mortality in the context of GOLD 2011 is unknown. OBJECTIVES: To describe changes in exercise tolerance and physical activity over time in patients with COPD and to test the hypothesis that lower baseline 6MWD or accelerometry step count is associated with increased risk of COPD-related hospitalization or all-cause mortality, independent of GOLD 2011 group. METHODS:Physical function and medical outcomes were prospectively assessed in 326 patients with moderate to severe COPD in INSPIRE-II, a randomized controlled trial of a coping skills training intervention. Cox models were used to determine if GOLD 2011 group, 6MWD, or accelerometry steps were associated with risk of COPD-related hospitalization or all-cause mortality. MEASUREMENTS AND MAIN RESULTS:Physical function declined over time in GOLD group D but remained stable in groups A, B, and C. GOLD classification was associated with time to death or first COPD-related hospitalization. Baseline 6MWD was more strongly associated with time to death or first COPD-related hospitalization (hazard ratio, 0.50 [95% confidence interval, 0.34, 0.73] per 150 m, P=0.0003) than GOLD 2011 classification. A similar relationship was observed for accelerometry steps (hazard ratio, 0.80 [95% confidence interval, 0.70, 0.92] per 1,000 steps, P=0.002). CONCLUSIONS:Exercise tolerance and daily physical activity are important predictors of hospitalization and mortality in COPD, independent of GOLD 2011 classification. Physical function may represent a modifiable risk factor that warrants increased attention as a target for interventions to improve clinically meaningful outcomes in COPD.
RCT Entities:
RATIONALE: The 2011 combined Global Initiative for Chronic Obstructive Lung Disease (GOLD) assessment incorporates symptoms, exacerbation history, and spirometry in discriminating risk of exacerbations in patients with chronic obstructive pulmonary disease (COPD). Six-minute-walk distance (6MWD) and accelerometry also have been used to assess disease severity in COPD. The association between these measures and the risks of hospitalization and mortality in the context of GOLD 2011 is unknown. OBJECTIVES: To describe changes in exercise tolerance and physical activity over time in patients with COPD and to test the hypothesis that lower baseline 6MWD or accelerometry step count is associated with increased risk of COPD-related hospitalization or all-cause mortality, independent of GOLD 2011 group. METHODS: Physical function and medical outcomes were prospectively assessed in 326 patients with moderate to severe COPD in INSPIRE-II, a randomized controlled trial of a coping skills training intervention. Cox models were used to determine if GOLD 2011 group, 6MWD, or accelerometry steps were associated with risk of COPD-related hospitalization or all-cause mortality. MEASUREMENTS AND MAIN RESULTS: Physical function declined over time in GOLD group D but remained stable in groups A, B, and C. GOLD classification was associated with time to death or first COPD-related hospitalization. Baseline 6MWD was more strongly associated with time to death or first COPD-related hospitalization (hazard ratio, 0.50 [95% confidence interval, 0.34, 0.73] per 150 m, P=0.0003) than GOLD 2011 classification. A similar relationship was observed for accelerometry steps (hazard ratio, 0.80 [95% confidence interval, 0.70, 0.92] per 1,000 steps, P=0.002). CONCLUSIONS: Exercise tolerance and daily physical activity are important predictors of hospitalization and mortality in COPD, independent of GOLD 2011 classification. Physical function may represent a modifiable risk factor that warrants increased attention as a target for interventions to improve clinically meaningful outcomes in COPD.
Authors: P W Jones; G Brusselle; R W Dal Negro; M Ferrer; P Kardos; M L Levy; T Perez; J J Soler Cataluña; T van der Molen; L Adamek; N Banik Journal: Eur Respir J Date: 2011-05-12 Impact factor: 16.671
Authors: Peter Lange; Jacob Louis Marott; Jørgen Vestbo; Kim Rose Olsen; Truls Sylvan Ingebrigtsen; Morten Dahl; Børge Grønne Nordestgaard Journal: Am J Respir Crit Care Med Date: 2012-09-20 Impact factor: 21.405
Authors: Jørgen Vestbo; Suzanne S Hurd; Alvar G Agustí; Paul W Jones; Claus Vogelmeier; Antonio Anzueto; Peter J Barnes; Leonardo M Fabbri; Fernando J Martinez; Masaharu Nishimura; Robert A Stockley; Don D Sin; Roberto Rodriguez-Roisin Journal: Am J Respir Crit Care Med Date: 2012-08-09 Impact factor: 21.405
Authors: Ane Johannessen; Roy M Nilsen; Michael Storebø; Amund Gulsvik; Tomas Eagan; Per Bakke Journal: Am J Respir Crit Care Med Date: 2013-07-01 Impact factor: 21.405
Authors: Joan B Soriano; Inmaculada Alfageme; Pere Almagro; Ciro Casanova; Cristobal Esteban; Juan J Soler-Cataluña; Juan P de Torres; Pablo Martinez-Camblor; Marc Miravitlles; Bartolome R Celli; Jose M Marin Journal: Chest Date: 2013-03 Impact factor: 9.410
Authors: Christopher J Dondzila; Ann M Swartz; Nora E Miller; Elizabeth K Lenz; Scott J Strath Journal: Int J Behav Nutr Phys Act Date: 2012-12-11 Impact factor: 6.457
Authors: Martijn A Spruit; Michael I Polkey; Bartolome Celli; Lisa D Edwards; Michael L Watkins; Victor Pinto-Plata; Jørgen Vestbo; Peter M A Calverley; Ruth Tal-Singer; Alvar Agusti; Harvey O Coxson; David A Lomas; William MacNee; Stephen Rennard; Edwin K Silverman; Courtney C Crim; Julie Yates; Emiel F M Wouters Journal: J Am Med Dir Assoc Date: 2011-07-21 Impact factor: 4.669
Authors: Emily S Wan; Ana Kantorowski; Diana Homsy; Merilee Teylan; Reema Kadri; Caroline R Richardson; David R Gagnon; Eric Garshick; Marilyn L Moy Journal: Respir Med Date: 2017-07-25 Impact factor: 3.415
Authors: James A Blumenthal; Patrick J Smith; Michael Durheim; Stephanie Mabe; Charles F Emery; Tereza Martinu; Philip T Diaz; Michael Babyak; Karen Welty-Wolf; Scott Palmer Journal: Psychosom Med Date: 2016 Feb-Mar Impact factor: 4.312
Authors: Emily S Wan; Ana Kantorowski; Madeline Polak; Reema Kadri; Caroline R Richardson; David R Gagnon; Eric Garshick; Marilyn L Moy Journal: Respir Med Date: 2020-01-11 Impact factor: 3.415
Authors: Abebaw Mengistu Yohannes; Patrick J Raue; Dora Kanellopoulos; Amanda McGovern; Jo Anne Sirey; Dimitris N Kiosses; Samprit Banerjee; Joanna K Seirup; Richard S Novitch; George S Alexopoulos Journal: Chest Date: 2016-01-12 Impact factor: 9.410
Authors: Jade Schrijver; Anke Lenferink; Marjolein Brusse-Keizer; Marlies Zwerink; Paul Dlpm van der Valk; Job van der Palen; Tanja W Effing Journal: Cochrane Database Syst Rev Date: 2022-01-10
Authors: Valentin Prieto-Centurion; Nina Bracken; Lourdes Norwick; Farhan Zaidi; Amelia A Mutso; Victoria Morken; David B Coultas; Cynthia S Rand; David X Marquez; Jerry A Krishnan Journal: Chronic Obstr Pulm Dis Date: 2016
Authors: Megan Huisingh-Scheetz; Kristen Wroblewski; Linda Waite; Elbert S Huang; L Philip Schumm; Donald Hedeker Journal: J Gerontol A Biol Sci Med Sci Date: 2021-08-13 Impact factor: 6.053
Authors: David B Coultas; Bradford E Jackson; Rennie Russo; Jennifer Peoples; Karan P Singh; John Sloan; Minyong Uhm; Jamile A Ashmore; Steven N Blair; Sejong Bae Journal: Ann Am Thorac Soc Date: 2018-04