A Retrospective Cohort Study of pulmonary rehabilitation programs in patients with advanced COPD with chronic obstructive pulmonary disease

Kavita Iyer; P. Iyer; D. Patel

doi:10.5281/zenodo.22815199

Authors

Kavita Iyer Department of Clinical Respiratory Care, Guadalquivir Institute of Pulmonary Medicine Author https://orcid.org/6128-8478-0921-2894
P. Iyer Division of Respiratory Care, Uruguay Institute of Pulmonary Medicine Author https://orcid.org/8970-5993-5558-3698
D. Patel Division of Respiratory Care, Amur Research Center for Respiratory Care Author https://orcid.org/1268-9628-2464-042X

DOI:

https://doi.org/10.5281/zenodo.22815199

Keywords:

pulmonary rehabilitation, COPD, exercise capacity, dyspnoea, hospitalisation

Abstract

Graphical abstract

Background: Pulmonary rehabilitation (PR) improves exercise capacity, dyspnoea and quality of life in COPD, yet most trial evidence derives from moderate disease, leaving its effectiveness in advanced, GOLD stage III-IV patients under-documented.

Objective: This retrospective cohort study evaluated outcomes of structured outpatient PR programs in patients with advanced COPD, examining functional capacity, symptom burden, healthcare utilisation and program completion.

Methods: We reviewed records of 412 patients with GOLD stage III-IV COPD referred to three hospital-affiliated PR programs over six years, comparing six-minute walk distance, St George's Respiratory Questionnaire scores, dyspnoea grade and 12-month exacerbation-related hospitalisation between completers and non-completers.

Results: Completers (n=289, 70.1%) achieved a mean six-minute walk distance improvement of 42.6 m and a St George's Respiratory Questionnaire reduction of 9.8 points, exceeding minimal clinically important differences, alongside a 34% relative reduction in exacerbation-related hospitalisation.

Conclusions: Structured PR confers clinically meaningful functional and symptomatic benefit even in advanced COPD, though completion rates remain a limiting factor warranting targeted strategies to reduce attrition.

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