Pulmonary rehabilitation for patients with COPD during and after an exacerbation-related hospitalisation: back to the future?. Issue 1 (11th January 2018)

• Record Type: Journal Article
• Authors: Wilson, Kevin C.; Krishnan, Jerry A.; Sliwinski, Pawel; Criner, Gerard J.; Miravitlles, Marc; Hurst, John R.; Calverley, Peter M.A.; Albert, Richard K.; Rigau, David; Tonia, Thomy; Vestbo, Jørgen; Papi, Alberto; Rabe, Klaus F.; Anzueto, Antonio; Wedzicha, Jadwiga A.
• Is Part Of: European respiratory journal. Volume 51:Issue 1(2018)
• Publication Date: 2018-01-11
• Subjects: Respiratory organs -- Diseases -- Periodicals; Respiration -- Periodicals; 616.2
• DOI: 10.1183/13993003.02577-2017
• Languages: English
• ISSNs: 0903-1936

Abstract

We thank M.A. Spruit and colleagues for their questions about our decisions regarding initiating pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD) exacerbations. Their main objection is the recommendation against initiating pulmonary rehabilitation during the patient's hospitalisation. We agree that the recommendation was based primarily on the finding of increased mortality (6-min walking test had statistically significant improvement and hospital readmission had non-statistically significant improvement) and that the trial led by Greening et al . [1] contributed 389 out of 415 patients. We further agree that there is uncertainty about whether or not inpatient-initiated pulmonary rehabilitation is associated with increased mortality, particularly since the mortality difference emerged more than 5 months after hospital discharge in the study by Greening et al . [1] and that the per protocol analysis in this study found no difference in mortality among those who actually received pulmonary rehabilitation versus the control group. Guideline recommendation against the initiation of pulmonary rehabilitation during hospitalisation was justified http://ow.ly/ve2L30hiqop