The benefits of pulmonary rehabilitation in COPD are evident for 12 months then diminish to below pre-program levels, Queensland research shows.
Emergency department presentations and hospital lengths of stay for COPD were significantly reduced in 426 people who undertook an eight week pulmonary rehab course, an observational study conducted at the Prince Charles Hospital, Brisbane, found.
But the benefits, seen in patients with an average FEV1 of 49.3 % predicted at baseline, were seen only in the first 12 months after undergoing pulmonary rehab. In the subsequent 12-24 month period the rates of hospitalisation significantly increased above pre-program levels.
Published in the BMJ Open, the study showed that emergency department presentations/person/year decreased from a pre-program level of 1.15 to 0.9 in the first 12 months after pulmonary rehab (p=0.003); but increased in the 12–24 months period to 2.0 (p<0.001).
There was no significant decrease in respiratory admissions after pulmonary rehab but the hospital days/person/year decreased from 4.0 to 2.5 in the 12 months after pulmonary rehab (p<0.001), then increased in the 12–24 months period to 6.1 days, (p=0.004).
The researchers said the greatest benefit from pulmonary rehab was seen in patients who had at least one pre-program respiratory-related hospital admission.
In this group there was a 39% mean reduction in the number of respiratory-related hospitals admissions, a 50% decrease in days spent in hospital (50.5%) and a 33% decrease in the number of ED presentations during the first 12 months post program when compared with the preceding 12 months.