Abstract
Background: Comorbidities affect quality of life and physical capacity of people with COPD (chronic obstructive pulmonary disease). The COTE (COPD-specific comorbidity test) index has been used to assess mortality risk but is not widely used in pulmonary rehabilitation (PR).
Aim: To investigate the relationship of the COTE index with PR outcomes.
Methods: Secondary analysis of data from a randomised controlled equivalence trial of home or centre-based PR in stable COPD (n=166). Comorbidities (medical records) were documented as COTE index score, COTE ≥4 (marker of poor prognosis) vs. <4, and comorbidity count (number of comorbidities). Outcomes were pre to post PR change (∆) in 6-minute walk distance (6MWD), Chronic Respiratory Questionnaire dyspnoea domain (CRQD), 36-item Short Form Health Survey (v2) physical component score (PCS) and sedentary time (ST, SenseWear; n=50).
Results: There was no significant difference in COTE ≥4 between PR groups (19% home, 22% centre, p=0.56). Of participants with COTE ≥4 (n=34), only 53% completed PR (73% COTE <4, p=0.021). There were no between-group differences (COTE <4, ≥4) for ∆6MWD (mean difference -5 metres [95%CI -28, 18]) or ∆CRQD (-1.0 point [-3.5, 1.6]). Participants with COTE ≥4 showed less PCS improvement (-4 [-8, -0.1]) and greater ST reduction (-170 minutes [-295, -44]). Correlations of COTE score with ∆PCS (r=-0.209, p=0.010) and ∆ST (r=-0.366, p=0.008) were shown. There were no relationships with any outcome for comorbidity count.
Conclusions: Participants with more comorbidities demonstrated similar improvements and a larger reduction in ST, but poorer PR completion highlights the need for improved program access for this group to obtain important health benefits.
Footnotes
Cite this article as: European Respiratory Journal 2018 52: Suppl. 62, PA3647.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2018