Functional status in high and low risk patient with chronic obstructive pulmonary disease

Aim: Acute exacerbations have an important effect on functional status of patients with chronic obstructive pulmonary disease (COPD). The purpose of this study was to compare physical and functional capacity in high and low risk patients with COPD. Methods: Forty-nine clinically stable patients with COPD (35 M, 14 F, age=60.6±11.1 years, FEV1=57.3±20.2%) participated in the study. Subjects’ demographic and physical characteristics were recorded. Patients were divided in to two groups according to acute exacerbation risk (number of exacerbations per year and GOLD stage). Pulmonary function testing and six-minute walk test (6MWT) were performed. Respiratory muscle strength (MIP and MEP) was measured. Perception of dyspnea using the modified Medical Research Council dyspnea scale and perception of fatigue using the Fatigue Severity Scale (FSS) were determined. Health status was evaluated using the Clinical COPD Questionnaire (CCQ). Level of activities of daily living was determined using London Chest Activities of Daily Living Scale (LCADL). Results: Body weight, FEV1, FVC, PEF, FEF25-75%, MIP, and 6MWT distance of high risk patients were significantly lower but their CCQ score, FSS score, and LCADL-physical score were significantly higher than those of low risk patients (p<0.05). Conclusion: The COPD patients with high risk for acute exacerbation have lower weight, impaired lung function, inspiratory muscle strength, functional exercise capacity, health status and activities of daily living, and experienced higher levels of fatigue. Pulmonary rehabilitation components which may be effective in high risk and low risk COPD phenotypes may be different.