1. Physical Activity Is the Strongest Predictor of All-Cause Mortality in Patients With COPD
- Author
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Kai-Christian Müller, Anne Kirsten, Benjamin Waschki, Thorsten Meyer, Henrik Watz, Helgo Magnussen, and Olaf Holz
- Subjects
Pulmonary and Respiratory Medicine ,Spirometry ,COPD ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Hazard ratio ,Critical Care and Intensive Care Medicine ,Lower risk ,medicine.disease ,Internal medicine ,Cohort ,medicine ,Physical therapy ,Mass index ,Cardiology and Cardiovascular Medicine ,Prospective cohort study ,business ,Cohort study - Abstract
Background Systemic effects of COPD are incompletely reflected by established prognostic assessments. We determined the prognostic value of objectively measured physical activity in comparison with established predictors of mortality and evaluated the prognostic value of noninvasive assessments of cardiovascular status, biomarkers of systemic inflammation, and adipokines. Methods In a prospective cohort study of 170 outpatients with stable COPD (mean FEV1, 56% predicted), we assessed lung function by spirometry and body plethysmography; physical activity level (PAL) by a multisensory armband; exercise capacity by 6-min walk distance test; cardiovascular status by echocardiography, vascular Doppler sonography (ankle-brachial index [ABI]), and N-terminal pro-B-type natriuretic peptide level; nutritional and muscular status by BMI and fat-free mass index; biomarkers by levels of high-sensitivity C-reactive protein, IL-6, fibrinogen, adiponectin, and leptin; and health status, dyspnea, and depressive symptoms by questionnaire. Established prognostic indices were calculated. The median follow-up was 48 months (range, 10-53 months). Results All-cause mortality was 15.4%. After adjustments, each 0.14 increase in PAL was associated with a lower risk of death (hazard ratio [HR], 0.46; 95% CI, 0.33-0.64; P Conclusions We found that objectively measured physical activity is the strongest predictor of all-cause mortality in patients with COPD. In addition, adiponectin level and vascular status provide independent prognostic information in our cohort.
- Published
- 2011