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Short-stay comprehensive inpatient pulmonary rehabilitation for advanced chronic obstructive pulmonary disease
Objective:
To evaluate the effectiveness of short-term, comprehensive inpatient pulmonary rehabilitation in severe chronic obstructive pulmonary disease (COPD).
Design:
Retrospective analysis of several outcome measures.
Setting:
Inpatient pulmonary rehabilitation unit.
Participants:
Thirty-eight consecutive adult patients with advanced COPD referred to our inpatient pulmonary rehabilitation program between January 1 and December 31, 1994. All but one were referred from acute care hospitals. The mean forced expiratory volume in 1 second (FEV1) was .69L; 79% required supplemental oxygen.
Main Outcome Measures:
(1) Discharge status; (2) timed walk, with measurements of distance and exertional dyspnea; and (3) functional status.
Results:
All patients were able to be discharged home after a mean length of stay of 9.9 days. The 12-minute walk distance increased by 66%, from 416 +/- 282 feet to 690 +/- 337 feet (p < .001). Dyspnea during the walk testing also improved: the resting score decreased from 2.87 to .97, the 6-minute score from 7.84 to 3.05, and postwalk score from 8.53 to 3.51 (all p < .001). All patients showed improvement in the Pulmonary Function Status Scale (PFSS), with the functional activities subsection increasing by 39%, the dyspnea score by 65%, and psychosocial score by 35% (all p < .001).
Conclusion:
Short-term improvement in multiple areas can be accomplished with comprehensive pulmonary rehabilitation of short duration. This is particularly relevant to the current health care environment that dictates shorter in-hospital lengths of stay.