| Title |
Increased mortality in patients with severe COPD associated with high-intensity exercise: a preliminary cohort study
|
|---|---|
| Published in |
International Journal of Chronic Obstructive Pulmonary Disease, September 2016
|
| DOI | 10.2147/copd.s114911 |
| Pubmed ID | |
| Authors |
Lone Schaadt, Robin Christensen, Lars Erik Kristensen, Marius Henriksen |
| Abstract |
Intensity of exercise is believed to be a key determinant of response to chronic obstructive pulmonary disease (COPD) rehabilitation. We hypothesized that a higher intensity of exercise, in combination with physiotherapist-led instructions and education in management of breathlessness, would lead to better self-management, possibly delaying calls to the emergency service and preventing hospitalization. We aimed to test this hypothesis in a subsequent randomized trial, and in order to test study processes and estimate hospitalization rates, we did a small preliminary prospective cohort study on severe COPD patients referred to outpatient rehabilitation. In 2013, four rehabilitation courses were scheduled (spring, summer, autumn, and winter) each lasting 8 weeks and including eight to ten patients. This preliminary study was designed as a controlled cohort study. The bi-weekly exercise sessions in the spring and autumn courses included a high-intensity walking exercise at 95% of estimated VO2 max for as long as possible. The other two rehabilitation courses included the usual walking exercise intensity (85% of estimated VO2 max). Hospitalization rates were assessed from the participants' medical records in an 18-month period. We were able to enroll 31 patients in total (15 in the high-intensity exercise group and 16 in regular intensity). There were no group differences in the hospitalization rates. However, during review of the medical records, we observed a striking mortality rate among participants who had attended the high-intensity rehabilitation courses (five deaths) compared to the standard rehabilitation (zero deaths). Four of the five deaths were COPD exacerbations. Fisher's exact test was statistically significant (P=0.046), as was a log-rank test (P=0.019) of the Kaplan-Meier estimated survival rates. These results from this small preliminary cohort study are alarming and raise concerns about the possible serious risks associated with high-intensity exercise rehabilitation of severe COPD patients. |
X Demographics
The data shown below were collected from the profiles of 6 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Argentina | 1 | 17% |
| Australia | 1 | 17% |
| United States | 1 | 17% |
| United Kingdom | 1 | 17% |
| Unknown | 2 | 33% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 5 | 83% |
| Scientists | 1 | 17% |
Mendeley readers
The data shown below were compiled from readership statistics for 137 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 1 | <1% |
| Unknown | 136 | 99% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 23 | 17% |
| Student > Ph. D. Student | 15 | 11% |
| Student > Bachelor | 15 | 11% |
| Student > Doctoral Student | 9 | 7% |
| Researcher | 8 | 6% |
| Other | 17 | 12% |
| Unknown | 50 | 36% |
| Readers by discipline | Count | As % |
|---|---|---|
| Nursing and Health Professions | 29 | 21% |
| Medicine and Dentistry | 22 | 16% |
| Sports and Recreations | 9 | 7% |
| Agricultural and Biological Sciences | 3 | 2% |
| Social Sciences | 3 | 2% |
| Other | 13 | 9% |
| Unknown | 58 | 42% |
Attention Score in Context
This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 August 2017.
All research outputs
#7,778,730
of 25,374,917 outputs
Outputs from International Journal of Chronic Obstructive Pulmonary Disease
#916
of 2,577 outputs
Outputs of similar age
#112,633
of 348,371 outputs
Outputs of similar age from International Journal of Chronic Obstructive Pulmonary Disease
#46
of 104 outputs
Altmetric has tracked 25,374,917 research outputs across all sources so far. This one has received more attention than most of these and is in the 69th percentile.
So far Altmetric has tracked 2,577 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.5. This one has gotten more attention than average, scoring higher than 63% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 348,371 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 67% of its contemporaries.
We're also able to compare this research output to 104 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 54% of its contemporaries.