Functional Capacity and Physical Activity in COPD: Associations with Hospitalizations, Health related Quality of Life and Mortality. A Prospective study

ABSTRACT Objective To demonstrate the association between hospital admissions, health-related quality of life (HRQoL), limitations in daily activities, mortality, and survival in relation to physical activity (PA) and functional capacity (FC), which were used together to classify a cohort of COPD patients. Methods Prospective study. Participants were consecutively recruited from six outpatient respiratory clinics of a single university hospital. Data were recorded on sociodemographic and clinical variables, dyspnea (Medical Research Council), HRQoL (Saint George’s Respiratory Questionnaire (SGRQ) and COPD Assessment Test (CAT)), and limitation of daily life (London Chest Activity of Daily Living scale (LCADL)). FC was evaluated with a 6-minute walk test. PA (average daily steps) was measured using an accelerometer. Participants were grouped into four “CanDo/DoDo” quadrants based on their PA and FC combinations. Results 401 patients were included. Compared to the “Can/Do” group, the “Can’t/Do” (Odds Ratio (OR): 3.34) and the “Can’t/Don’t” (OR: 27.3) groups had a higher risk of dying within one year, worse survival rates (Hazard Ratios: 2.37 and 2.87), and a higher risk of hospital admission (OR: 2.83 and 2.84) and additional admissions (Incidence Rate Ratios of 2.58 and 2.31) in the first year of follow-up. The “Can’t/Do” and the “Can’t/Don’t” groups had worse scores on the SGRQ (OR: 1.83 and 2.15), CAT (OR: 2.44 and 3.39), and LCADL (OR: 1.31 and 1.42) questionnaires conducted at the beginning of the study. Conclusion Using PA and FC quadrants to classify participants showed associations with robust outcomes, thus enabling strategies to be developed to improve those outcomes.