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* From Hospital for Special Care (Ms. Bowen and Drs. Votto and Thrall), New Britain, CT; Norwalk Hospital (Ms. Haggerty), Norwalk, CT; St. Raphael Hospital (Ms. Stockdale-Woolley), New Haven, CT; University of Connecticut Health Center (Dr. Bandyopadhyay), Farmington, CT; and St. Francis Hospital & Medical Center (Dr. ZuWallack), Hartford, CT
Correspondence to: Janet Bowen, BA, CRTT, Department of Research, Hospital for Special Care, 2150 Corbin Ave, New Britain, CT 06053; e-mail: bowenj{at}hfsc.org
Background: Functional exercise capacity has been shown to be a strong predictor of survival following pulmonary rehabilitation. This study evaluated whether questionnaire-rated functional status is also predictive of survival.
Patients and methods: Following pulmonary rehabilitation, patients with advanced chronic lung disease were evaluated for survival, 6-min walk distance, and questionnaire-rated functional status. The latter was measured using the pulmonary functional status scale, which has subscores of functional activities, psychological status, and dyspnea. Information on survival was available on 149 patients.
Results: The mean age was 69 years, and 45% of patients were male. Eighty-nine percent had a diagnosis of COPD, and their FEV1 was 37 ± 18% of predicted. Ninety-one (61%) were married. The 3-year survival for the group was 85%. Age, gender, body mass index, and primary diagnosis were not related to survival. Variables strongly associated with increased survival following pulmonary rehabilitation included a higher postrehabilitation Functional Activities score, a longer postrehabilitation 6-min walk distance, and being married (vs widowed, single, or divorced). Disease severity variables associated with survival included an initial referral to outpatient pulmonary rehabilitation, no supplemental oxygen requirement, and a higher percent-predicted FEV1.
Conclusion: Indicators of functional status are strong predictors of survival in patients with advanced lung disease.
Key Words: pulmonary • questionnaire • rehabilitation • status • survival
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