Effect of complex sanatorium treatment on some dyspnea indices in patients with chronic obstructive pulmonary disease

The complex treatment of patients with chronic obstructive pulmonary disease (COPD) administered in a sanatorium environment is an effective therapeutic option for this condition as it involves conduction of a combination of climatic, therapeutic and rehabilitation procedures for a longer period of time. We studied the effect of this therapeutic modality on the dyspnea indices of COPD patients and the implication these indices have for the outcome of the treatment. The study was performed in the sanatorium of the State Hospital for Lung Diseases in Raduntzi, Bulgaria. It included 75 patients (65 men, 11 women) with different forms of stable COPD (mean age, 56.8 +/- 1.0 years, mean +/- SEM, FEV1% predicted--37.3 +/- 1.6%, mean duration of sanatorium stay 14 +/- 0.4 days). During the stay the patients received anti-obstructive and anti-inflammatory therapy based on the clinical discretion of the attending physician. All patients attended a rehabilitation programme according to their conditions; oxygen therapy was used in three patients. Of the 75 patients, 50 (66.7%) showed improvement at discharge, 21 (28%) had no improvement, and 4 (5.3%) were discharged in deteriorated condition. The complex treatment resulted in a minimal but statistically significant improvement of the basic spirographic and dyspnea parameters. This improvement depended not so much on the type of therapy administered as on the initial dyspnea and blood gas parameters. The body mass index (BMI) can also be used as a prognostic indicator especially if it is lower than 20 kg/m2. The lower this index is the lower the basic functional parameters are--in spite of using all available treatments, our patients with low body mass index rarely showed any noticeable improvement.