COPD: pulmonary rehabilitation soon after hospitalization saves lives

  • Lindenauer PK & al.
  • JAMA
  • 12 May 2020

  • curated by Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • Pulmonary rehabilitation begun within 90 days of hospital discharge for COPD is associated with a 37% greater survival at 1 year compared with rehabilitation begun after 90 days or not at all.

Why this matters

  • An accompanying editorial says that this effective treatment for COPD should be used "routinely and proactively" and that the findings should encourage health care systems to emphasize pulmonary rehabilitation services for these patients.

Study design

  • Retrospective cohort study of 197,376 Medicare patients (with fee-for-service coverage) hospitalized for COPD in 2014.
  • Funding: NIH.

Key results

  • 19.4% of hospitalized patients died within 1 year of discharge, including 7.3% who began pulmonary rehabilitation within 90 days and 19.6% beginning after that or not at all.
  • Starting rehabilitation within 90 days was associated with a lower risk for death over 1 year, with absolute risk difference of −6.7% (HR, 0.63; P<.001 compared with starting after days or not at all.>
  • Every 3 extra sessions of pulmonary rehabilitation was associated with lower risk for death (HR, 0.91; P=.01).

Limitations

  • Retrospective, observational.
  • Reliance on claims data.