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Puntos de corte para el comportamiento sedentario y su capacidad para predecir la mortalidad en personas con EPOC: un

Lais Santin¹, Humberto Silva¹, Thais Moçatto Tofoli¹

¹Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, Universidade Estadual de Londrina, Londrina, Brazil.

Chronic respiratory disease

|August 23, 2025

Resumen

El tiempo sedentario superior a 8,5 horas diarias está relacionado con un mayor riesgo de mortalidad en individuos con enfermedad pulmonar obstructiva crónica (EPOC) estable. Este hallazgo pone de relieve la importancia de controlar el comportamiento sedentario para un mejor manejo y pronóstico de la EPOC.

Área de la Ciencia:

Medicina de los pulmones
Gerontología
Epidemiología

Sus antecedentes:

El comportamiento sedentario es frecuente en personas con enfermedad pulmonar obstructiva crónica.
La asociación entre el tiempo sedentario y el riesgo de mortalidad en pacientes con EPOC requiere más investigación.
La identificación de umbrales específicos para el comportamiento sedentario es crucial para la estratificación del riesgo.

Objetivo del estudio:

Evaluar el valor predictivo de tres límites de comportamiento sedentario distintos para la mortalidad por todas las causas en pacientes estables con EPOC.
Para comparar la utilidad del tiempo sedentario (ST) >8,5 h/día, ST >70% del tiempo despierto, y <4300 pasos/día como predictores de mortalidad.
Establecer un umbral clínicamente relevante para el comportamiento sedentario en el tratamiento de la EPOC.

Principales métodos:

Análisis de los datos de referencia de 92 individuos con EPOC estable admitidos para rehabilitación pulmonar.
Aplicación de modelos de regresión multivariada de Cox para evaluar los predictores de mortalidad durante un seguimiento de 12 años.
Comparación de tres límites predefinidos para el comportamiento sedentario: ST > 8,5 h/día, ST > 70% de tiempo despierto y < 4300 pasos/día.

Principales resultados:

El tiempo sedentario superior a 8,5 horas por día (ST > 8,5 h/día) fue identificado como un predictor independiente de la mortalidad por cualquier causa.
Los pacientes con ST > 8,5 horas/ día presentaron un riesgo de mortalidad un 23% mayor (HR 1,23, IC del 95% 1,021-1,589, P=0,02).
Los otros dos puntos de corte evaluados para el comportamiento sedentario no mostraron una asociación significativa con la mortalidad.

Conclusiones:

Un umbral de tiempo sedentario de > 8,5 horas por día es un indicador significativo de mayor riesgo de mortalidad en individuos con EPOC estable.
El monitoreo y la reducción del comportamiento sedentario prolongado pueden ser una estrategia de intervención crítica para mejorar la supervivencia en pacientes con EPOC.
ST >8,5 h/día sirve como un marcador valioso para identificar a las personas con EPOC de alto riesgo para un seguimiento más cercano y intervenciones específicas.

Palabras clave:

enfermedad pulmonar obstructiva crónica la mortalidad comportamiento sedentario Análisis de la supervivencia

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