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Prognosis and longitudinal changes of physical activity in idiopathic pulmonary fibrosis

Bahmer, Thomas ; Kirsten, Anne-Marie ; Waschki, Benjamin ; Rabe, Klaus F. ; Magnussen, Helgo ; Kirsten, Detlef ; Gramm, Marco ; Hummler, Simone ; Brunnemer, Eva ; Kreuter, Michael ; Watz, Henrik

In: BMC Pulmonary Medicine, 17 (2017), Nr. 104. pp. 1-8. ISSN 1471-2466

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Download (702kB) | Lizenz: Creative Commons LizenzvertragPrognosis and longitudinal changes of physical activity in idiopathic pulmonary fibrosis by Bahmer, Thomas ; Kirsten, Anne-Marie ; Waschki, Benjamin ; Rabe, Klaus F. ; Magnussen, Helgo ; Kirsten, Detlef ; Gramm, Marco ; Hummler, Simone ; Brunnemer, Eva ; Kreuter, Michael ; Watz, Henrik underlies the terms of Creative Commons Attribution 3.0 Germany

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Abstract

Background: Physical activity (PA) is associated with disease severity in idiopathic pulmonary fibrosis (IPF), but longitudinal studies evaluating its prognostic value and changes over time are lacking. Methods: We measured PA (steps per day, SPD) in a cohort of 46 IPF-patients (mean age, 67 years; mean FVC, 76.1%pred.) by accelerometry at baseline, recorded survival status during 3 years follow-up and repeated measurements in survivors. We compared the prognostic value of PA to established mortality predictors including lung function (FVC, DLCO) and 6-min walking-distance (6MWD). Results: During follow-up (median 34 months) 20 patients (43%) died. SPD and FVC best identified non-survivors (AUROC-curve 0.79, p < 0.01). After adjustment for confounders (sex, age, therapy), a standardized increase (i.e. one SD) in SPD, FVC%pred. or DLCO%pred. was associated with a more than halved risk of death (HR < 0.50; p < 0.01). Compared to baseline, SPD, FVC, and 6MWD annually declined in survivors by 973 SPD, 130 ml and 9 m, resulting in relative declines of 48.3% (p < 0.001), 13.3% (p < 0.001) and 7.8% (p = 0.055), respectively. Conclusion: While PA predicts mortality of IPF patients similar to established functional measures, longitudinal decline of PA seems to be disproportionally large. Our data suggest that the clinical impact of disease progression could be underestimated by established functional measures.

Item Type: Article
Journal or Publication Title: BMC Pulmonary Medicine
Volume: 17
Number: 104
Publisher: BioMed Central
Place of Publication: London
Date Deposited: 03 Aug 2017 09:01
Date: 2017
ISSN: 1471-2466
Page Range: pp. 1-8
Faculties / Institutes: Medizinische Fakultät Heidelberg > Thoraxklinik Heidelberg gGmbH
Subjects: 610 Medical sciences Medicine
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