한빛사논문
- 조회542
Taeyun Kim MD 1,∗, Hyunsoo Kim MS 2,∗, Sunga Kong PhD 2,3, Sun Hye Shin MD PhD 1, Juhee Cho PhD 2,4, Danbee Kang PhD 2,4,¶, Hye Yun Park MD, PhD 1,¶
1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
2Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Republic of Korea
3Patient-Centered Outcomes Research Institute, Samsung Medical Center, Seoul, Republic of Korea
4Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea
∗These authors contributed equally to this article.
¶These authors contributed equally to this article.
Corresponding authors: Danbee Kang PhD, Hye Yun Park MD, PhD
Abstract
Background
Moderate-to-vigorous physical activity (MVPA) in patients with chronic obstructive pulmonary disease (COPD) affects their overall health outcomes, including symptom relief and improved quality of life. However, the magnitude of the effect of MVPA initiation on real-world clinical outcomes has not been well investigated.
Research Question
How does MVPA initiation impact mortality and severe exacerbation rates in patients who have not engaged in MVPA before COPD diagnosis?
Study Design and Methods
We included patients with COPD aged ≥40 years who were not performing MVPA before COPD diagnosis and had at least one health screening visit before and after their COPD diagnosis between January 1, 2010, and December 31, 2018. The main exposure was MVPA, defined as vigorous aerobic exercise over 20 minutes per day on ≥3 days per week or moderate aerobic exercise over 30 minutes per day on ≥5 days per week. The primary endpoint was the all-cause mortality rate, and the secondary endpoint was the initial severe exacerbation as the time to event after COPD diagnosis.
Results
In total, 110,097 person-trials were included (27,564 MVPA increases and 82,533 control groups). No differences were observed between the covariates after matching. The adjusted hazards ratio (HR) of all-cause mortality for the MVPA group compared to the control was 0.84 (95% confidence interval (CI): 0.79, 0.89). In subgroup analysis, patients aged >65, women, never smokers, and the higher Charlson comorbidity index (CCI) group showed a stronger effect of MVPA on reducing mortality than younger men, ever smokers, and the lower CCI group (p for interaction <0.05). The fully adjusted HR for the risk of severe exacerbation (MVPA group vs. control) was 0.90 (95% CI: 0.87, 0.94).
Interpretation
MVPA initiation can potentially reduce mortality and severe exacerbations in patients with COPD, although personalized interventions and further clinical trials are necessary.
논문정보
- Research article
- 2023년 07월 (BRIC 등록일 2023-07-25)
- 국내 연구진
- 의약학 > 응용의학
댓글 작성 로그인
팝업 닫기관련 링크
관련분야 연구자보기
소속기관 논문보기
관련분야 논문보기
해당논문 저자보기
