Cluster analysis identifying patients with COPD at high risk of 2-year all-cause mortality

Rodrigues, Antenor; Camillo, Carlos Augusto; Furlanetto, Karina Couto; Paes, Thaís; Morita, Andrea Akemi; Spositon, Thamyres; Donária, Leila; Ribeiro, Marcelo Leite; Probst, Vanessa Suziane; Hernandes, Nídia A.; Pitta, Fábio

doi:10.1177/1479972318809452

Cited by 8 publications

(14 citation statements)

References 24 publications

(67 reference statements)

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“… * According to Britto et al; ( 31 ) † according to Rodrigues et al. ; ( 32 ) ‡ according to Oliveira et al ( 33 ) COPD - chronic obstructive pulmonary disease; GOLD - Global Initiative for Chronic Obstructive Lung Disease; NYHA - New York Heart Association. …”

Section: Resultsmentioning

confidence: 99%

“… * According to Britto et al; ( 31 ) † according to Rodrigues et al. ; ( 32 ) ‡ according to Oliveira et al ( 33 ) …”

Section: Resultsmentioning

confidence: 99%

“…Categorical variables are expressed as counts and percentages. The paired sample t-test or the Wilcoxon sign rank-test were used to compare 6MWT distances completed by study participants with expected values for heathy individuals (adjusted by gender, age, and body mass index - BMI), ( 31 ) COPD subjects, ( 32 ) and heart failure subjects. ( 33 ) Stepwise multivariate linear regression was used to assess factors associated with the distance walked in the 6MWT.…”

Section: Methodsmentioning

confidence: 99%

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The 6-Minute Walk Test predicts long-term physical improvement among intensive care unit survivors: a prospective cohort study

Rosa

Dietrich

Valle

et al. 2021

Revista Brasileira De Terapia Intensiva

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Objetivo Avaliar a capacidade do Teste de Caminhada de 6 Minutos para predizer a melhora do estado funcional físico em longo prazo de pacientes sobreviventes à unidade de terapia intensiva. Métodos Foram avaliados, de forma prospectiva, entre fevereiro de 2017 e agosto de 2018, em um ambulatório pós-unidade de terapia intensiva, 32 sobreviventes à unidade de terapia intensiva. Foram inscritos consecutivamente os pacientes com permanência na unidade de terapia intensiva acima de 72 horas (para admissões emergenciais) ou acima de 120 horas (para admissões eletivas) que compareceram ao ambulatório pós-unidade de terapia intensiva 4 meses após receberem alta da unidade de terapia intensiva. A associação entre a distância percorrida no Teste de Caminhada de 6 Minutos realizado na avaliação inicial e a evolução do estado funcional físico foi avaliada durante 8 meses, com utilização do Índice de Barthel. Resultados A distância média percorrida no Teste de Caminhada de 6 Minutos foi significantemente mais baixa nos sobreviventes à unidade de terapia intensiva do que na população geral (405m versus 557m; p < 0,001). A idade (β = -4,0; p < 0,001) e a fraqueza muscular (β = -99,7; p = 0,02) se associaram com a distância percorrida no Teste de Caminhada de 6 Minutos. A distância percorrida no Teste de Caminhada de 6 Minutos se associou com melhora do estado funcional físico no período de 8 meses de acompanhamento desses pacientes (razão de chance para cada 10m: 1,07; IC95% 1,01 - 1,16; p = 0,03). A área sob a curva Característica de Operação do Receptor para predição da melhora funcional física pelo Teste de Caminhada de 6 Minutos foi de 0,72 (IC95% 0,53 - 0,88). Conclusão O Teste de Caminhada de 6 Minutos, realizado 4 meses após a alta da unidade de terapia intensiva, predisse com precisão moderada a melhora do estado funcional físico de sobreviventes à unidade de terapia intensiva.

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Section: Resultsmentioning

confidence: 99%

“… * According to Britto et al; ( 31 ) † according to Rodrigues et al. ; ( 32 ) ‡ according to Oliveira et al ( 33 ) …”

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

The 6-Minute Walk Test predicts long-term physical improvement among intensive care unit survivors: a prospective cohort study

Rosa

Dietrich

Valle

et al. 2021

Revista Brasileira De Terapia Intensiva

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“…Recently, Rodrigues and collaborators have suggested in a cluster analysis that the cut-off point of 427 meters in the TC6 is more sensitive to predict mortality in Brazilian patients with COPD than the cut-off point widely used in isolation and also suggested by BODE (e.g. 350 meters) 28 . In addition, Brazilian patients with COPD have a greater exercise capacity then= patients from other regions of the world 29 , which might justify the lower proportion of individuals with higher risk of death.…”

Section: Resultsmentioning

confidence: 99%

Mortality in COPD: Comparison of Different Predictors in Patients Seeking a Pulmonary Rehabilitation Program

et al. 2019

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Resumo É clinicamente relevante identificar fatores preditores de mortalidade isolados ou multidimensionais em pacientes com Doença Pulmonar Obstrutiva Crônica (DPOC). O objetivo desse esuto foi comparar diferentes fatores na identificação de pacientes classificados em alto risco de morte e identificar o valor prognóstico de fatores isolados frente ao índice BODE. Foram avaliados pacientes quanto a fatores associado a mortalidade: função pulmonar com a medida do volume expiratório forçado (VEF1); índice de massa corpórea (IMC); índice de massa magra corporal (IMMC); Incremental Shuttle Walk Test (ISWT) com a estimativa do consumo máximo de oxigênio (VO2máx); teste de caminhada de seis minutos (TC6min); escala Medical Research Council; índice BODE e tempo sedentário. Pontos de corte previamente associados com mortalidade foram utilizados para calcular a proporção de pacientes em alto risco. Análise de curva ROC foi utilizada para testar o valor prognóstico das variáveis isoladas frente ao BODE. Foram incluídos 162 pacientes (86 homens, idade 67±8 anos). As proporções de pacientes classificados em alto risco variaram de 12,6% até 76,5% de acordo com os oito fatores analisados (P<0,05 vs todos). A área sob a curva (AUC) desses fatores testados isoladamente frente ao índice BODE indicou insatisfatória capacidade discriminativa (0,26 < AUC < 0,44). Existe uma variabilidade expressiva na proporção dos pacientes classificados como “alto risco” de acordo com cada fator preditor de mortalidade. Além disso, a avaliação prognóstica do paciente obtida com o índice BODE não pode ser substituída pela avaliação de um único fator preditor. Palavras-chave: Doença Pulmonar Obstrutiva Crônica. Mortalidade. Exercício. AbstractIt is clinically relevant to identify isolated factors or multidimensional predictors of mortality in patients with Chronic Obstructive Pulmonary Disease (COPD). To compare different factors in the identification of patients classified as high risk of death and to identify the prognostic value of isolated factors against the BODE index. Patients were evaluated considering the factors associated with mortality: pulmonary function with forced expiratory volume (FEV1); body mass index (BMI); body mass index (LMWI); Incremental Shuttle Walk Test (ISWT) with estimation of maximal oxygen consumption (VO2max); six-minute walk test (6MWT); Medical Research Council scale; BODE index and sedentary time. Cut-off points previously associated with risk of death were used to calculate the proportion of patients at high risk of death. ROC curve analysis was used to test the prognostic value of each variable against the BODE index. A total of 162 patients (86 men, age 67 ± 8 years) were included. The proportions of patients classified as high risk ranged from 12.6 to 76.5% according to all eight factors analyzed (P <0.05 vs all). The area under the curve (AUC) of each factor analyzed against the BODE index indicated insufficient discriminative capacity (0.26 < AUC < 0.44). Conclusion: There is an expressive variability of patients classified as "high risk" according to each predictor factor. Moreover, the prognostic evaluation of the patient using the BODE index cannot be replaced by the assessment of a single predictive factor. Keywords: Chronic Obstructive Pulmonary Disease, Mortality, Exercise.

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“…This was a cross-sectional analysis with retrospective data from a convenience sample of patients evaluated in the Laboratory of Research in Respiratory Physiotherapy, State University of Londrina, Brazil. Subjects enrolled in these baseline-only analyses took part later in an unrelated longitudinal study [23]. This study was approved by the local ethical committee (n.123/09) and written informed consent was obtained from all participants.…”

Section: Methodsmentioning

confidence: 99%

Tossing and turning: association of sleep quantity–quality with physical activity in COPD

et al. 2020

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The association between characteristics of sleep and physical activity in daily life (PADL) was not yet investigated in depth in subjects with chronic obstructive pulmonary disease (COPD). This study evaluated if time spent/day in physical activity (PA) and sedentary behaviour are associated with sleep quantity and quality in this population.Sleep and PADL were objectively assessed by an activity monitor for 7 days and analysed on a minute-by-minute basis. Subjects also underwent spirometry and 6-min walking test (6 MWT).Fifty-five subjects with moderate-to-severe COPD (28 male, 67±8 years) were studied. Subjects with total time in bed/night (TIB) ≥9 h had higher wake after sleep onset than TIB 7–9 h and TIB≤7 h (195 [147–218] versus 117 [75–167] and 106 [84–156] min) and more fragmented sleep than TIB≤7 h (8.2 [6.7–14.3] versus 6.3 [5.6–6.9] sleeping bouts)(p<0.05 for all). Subjects with TIB≥9 h also spent more time/day in sedentary behaviour and less time/day in PA of light and moderate-to-vigorous intensity than those with TIB 7–9 h and ≤7 h. In multiple linear regression, TIB≥9 h was the only significant predictor of physical inactivity (β=−3.3 [−5.1, −1,6], p≤0.0001), accounting for 20% of its variation. Sleep fragmentation was frequent and more pronounced in physically inactive than active patients (7.5 [6.3–9.6] versus 6.4 [5.5–7.3] sleeping bouts; p=0.027).In summary, subjects with COPD with time in bed ≥9 h·night−1 have more fragmented sleep, are more sedentary and less physically active than those with <9 h·night−1, independently of the awake time. Sleep quality is frequently poor and even worse in patients classified as physically inactive.

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Cluster analysis identifying patients with COPD at high risk of 2-year all-cause mortality

Cited by 8 publications

References 24 publications

The 6-Minute Walk Test predicts long-term physical improvement among intensive care unit survivors: a prospective cohort study

The 6-Minute Walk Test predicts long-term physical improvement among intensive care unit survivors: a prospective cohort study

Mortality in COPD: Comparison of Different Predictors in Patients Seeking a Pulmonary Rehabilitation Program

Tossing and turning: association of sleep quantity–quality with physical activity in COPD

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