Exercise May Help Reduce Death Risk After COPD Hospitalization

Any level of moderate to vigorous physical activity can benefit patients hospitalized for a chronic obstructive pulmonary disease (COPD) episode.

Exercising even a little bit can help patients reduce their risk of death, which is especially important because death rates can be as high as 21% at the 1-year mark following a COPD hospitalization.

Previous research has found that high levels of physical activity can lead to shorter hospital stays, as well as decreased risk of acute exacerbations, death, and hospitalizations.

More recently, researchers conducted a retrospective study of 2370 patients hospitalized for COPD in an integrated health care system between January 1, 2011, and December 31, 2011. The patients self-reported their amount of moderate to vigorous physical activity routinely at outpatient visits prior to being hospitalized.

The majority of patients were inactive (73%), meaning they reported no moderate to vigorous physical activity per week. Around 17% were insufficiently active (1 to 149 minutes of activity per week) and 10% were active (≥150 minutes).

Over the 12-month study period, there were 464 deaths (20% of the patient population). Those who were active or even insufficiently active had a 28% lower risk of death compared with inactive patients in the 12 months following a COPD hospitalization.

The researchers concluded that any level of exercise could help lower a patient’s risk of death following COPD hospitalization. In addition, routine assessment of exercise in clinical care could help identify patients at risk for dying after hospitalization.

Study author Huong Q. Nguyen, PhD, RN, a research scientist at Kaiser Permanente Southern California, toldContemporary Clinicthat the best thing a retail clinician can do for a recently discharged COPD patient is to make a referral to a pulmonary rehabilitation program, which is guideline-recommended care.

“A warm handoff is ideal if the clinician works closely with the pulmonary rehab programs in the area,” Dr. Nguyen explained. “The clinician discusses with the patient and family the importance of improving physical functioning, gains patients' commitment, and the patient agrees to be connected to a pulmonary rehab program.”

If a rehab program is not available in the area, a retail clinician can alternatively refer the patient to a local community center or senior center where they can start out with gentle exercise classes, Dr. Nguyen said. Clinicians can also recommend local American Lung Association Better Breathers peer support groups or online resources like the COPD Foundation.

“For those who prefer to get physically active on their own in the convenience of their homes, clinicians could suggest starting small like marching in place during commercial breaks if patients are watching TV and slowly progressing to longer periods of walking,” Dr. Nguyen added.

It may be helpful to brainstorm some ways to get active, since patients know best what they are willing to do, Dr. Nguyen pointed out.

“Most important for the retail clinician is to understand patients' readiness for change, their preferences, and how they wish to be supported to become more physically active and providing the resources/referrals and advice,” Dr. Nguyen said.

These study findings were published inERJ Open Research.