Influence of comorbidities on the efficacy of pulmonary rehabilitation in patients with chronic obstructive pulmonary disease

Aim To evaluate the influence of comorbidities and aging on pulmonary rehabilitation ( PR ) efficacy in patients with chronic obstructive pulmonary disease ( COPD ). Methods This was a retrospective cohort study of patients with COPD attending an outpatient PR program. Comorbidity information was collected with the C harlson Index, BODE index and COPD ‐specific comorbidity test, and also included other common conditions not included in these indexes. The efficacy of PR was defined as a 54‐m increase in 6‐min walk distance or a four‐point decrease in S t. G eorge's R espiratory Q uestionnaire score. Patients were divided into two age groups according to the median age of 72 years. Results A total of 21 of 52 patients (40%) showed a clinically significant benefit by the 6‐min walk distance, and 29 patients (55.8%) by the S t. G eorge's R espiratory Q uestionnaire score. PR efficacy was not different between the elderly group and the younger group by either parameter. A total of 98% of the patients had at least one chronic comorbidity. Hypertension was the most frequently reported comorbidity (28.5%). Higher body mass index, H ospital A nxiety and D epression S cale anxiety score and S t. G eorge's R espiratory Q uestionnaire total score were associated with a good response to PR by the 6‐min walk distance. None of the individual comorbidities or indexes were correlated with the efficacy of PR . Multiple logistic regression analysis showed that body mass index was independently associated with the response to PR . Conclusions PR is equally effective in elderly and younger patients with COPD , with efficacy influenced by body mass index and anxiety. Geriatr Gerontol Int 2016; 16: 934–941.