Study: Frailty Affects 1 in 4 COPD Patients

One in 4 patients with chronic obstructive pulmonary disease (COPD) are affected by frailty, but a pulmonary rehabilitation program can significantly improve outcomes in these patients in the short term, according to a new study from the United Kingdom.

Frailty in older adults can lead to adverse outcomes, yet previous research had not investigated frailty, or its management, in patients with respiratory disease.
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To conduct their study, the researchers recruited 816 patients with COPD who participated in an 8-week outpatient pulmonary rehabilitation program at Harefield Hospital in the United Kingdom between November 2011 and January 2015. Patients’ mean age was 70 years.

The researchers measured frailty using the Fried criteria (weight loss, exhaustion, low physical activity, slowness, and weakness) at baseline and after patients completed the rehabilitation program.

After analyzing covariance and adjusting for age and sex, the researchers found that 25.6% of patients entering the rehabilitation program were frail. These patients were twice as likely to not complete the program.

However, rehabilitation improved patient outcomes: 71 of the 115 patients who completed the program were no longer classified as frail at the end of the program.

“Frailty affects 1 in 4 patients with COPD referred for pulmonary rehabilitation and is an independent predictor of program non-completion,” the researchers concluded. “However, patients who are frail respond favorably to rehabilitation and their frailty can be reversed in the short term.”

—Amanda Balbi

Reference:

Maddocks M, Kon SSC, Canavan JL, et al. Physical frailty and pulmonary rehabilitation in COPD: a prospective cohort study [published online June 12, 2016]. Thorax. doi:10.1136/thoraxjnl-2016-208460.