Efficacy of standard Rehabilitation in COPD Outpatients with Co-morbidities.

A prospective study was performed to 1) confirm the prevalence pattern of the most frequent co-morbidities and 2) evaluate whether characteristics of patients, specific co-morbidities, and increasing number of co-morbidities are independently associated with poorer outcomes in a population of complex COPD submitted to rehabilitation (PR). Three-hundred and sixteen outpatients (age 68±7 yrs) were studied. Co-morbidities and proportion of patients with a pre-defined minimally significant change in exercise tolerance (6MWD, +54 mt), breathlessness (MRC score, -1 point) and quality-of-life (SGRQ, -4 points) as outcomes were recorded. Sixty-two % of patients reported co-morbidities; systemic hypertension (35%), dyslipidemia (13%), diabetes (12%), and coronary disease (11%) were the most frequent. Above 45% of them improved over MCID in all the outcomes. In a logistic regression model, baseline 6MWD (OR 0.99 95%CI 0.98-0.99, p=0.001), MRC (OR 12.88 95%CI 6.89-24.00, p=0.001), and PaCO2 (OR 1.08 95%CI 1.00-1.15, p=0.034) related with the proportion of patients who improved 6MWD and MRC, respectively. Presence of osteoporosis reduced the success rate in 6MWD (OR 0.28 95%CI 0.11-0.70, p=0.006). A substantial prevalence of co-morbidities in COPD outpatients referred to rehabilitation was confirmed. The individual’s disability and the presence of osteoporosis only were independently associated with poorer rehabilitation outcomes. (registered at ClinicalTrials.gov: NCT00992498.)