PMID- 34462346
OWN - NLM
STAT- MEDLINE
DCOM- 20220519
LR  - 20220707
IS  - 1468-3296 (Electronic)
IS  - 0040-6376 (Linking)
VI  - 77
IP  - 6
DP  - 2022 Jun
TI  - Survival after inpatient or outpatient pulmonary rehabilitation in patients with 
      fibrotic interstitial lung disease: a multicentre retrospective cohort study.
PG  - 589-595
LID - 10.1136/thoraxjnl-2021-217361 [doi]
AB  - BACKGROUND: The impact of pulmonary rehabilitation (PR) on survival in patients 
      with fibrotic interstitial lung disease (ILD) is unknown. Given the challenges 
      conducting a large randomised controlled trial, we aimed to determine whether 
      improvement in 6-minute walk distance (6MWD) was associated with better survival. 
      METHODS: This retrospective, international cohort study included patients with 
      fibrotic ILD participating in either inpatient or outpatient PR at 12 sites in 5 
      countries. Multivariable models were used to estimate the association between 
      change in 6MWD and time to death or lung transplantation accounting for 
      clustering by centre and other confounders. RESULTS: 701 participants (445 men 
      and 256 women) with fibrotic ILD were included. The mean+/-SD ages of the 196 
      inpatients and 505 outpatients were 70+/-11 and 69+/-12 years, respectively. 
      Baseline/changes in 6MWD were 262+/-128/55+/-83 m for inpatients and 358+/-125/34+/-65 m 
      for outpatients. Improvement in 6MWD during PR was associated with lower hazard 
      rates for death or lung transplant on adjusted analysis for both inpatient (HR 
      per 10 m 0.94, 95% CI 0.91 to 0.97, p<0.001) and outpatient PR (HR 0.97, 95% CI 
      0.95 to 1.00, p=0.042). Participation in >/=80% of planned outpatient PR sessions 
      was associated with a 33% lower risk of death (95% CI 0.49% to 0.92%). 
      CONCLUSIONS: Patients with fibrotic ILD who improved physical performance during 
      PR had better survival compared with those who did not improve performance. 
      Confirmation of these hypothesis-generating findings in a randomised controlled 
      trial would be required to definitely change clinical practice, and would further 
      support efforts to improve availability of PR for patients with fibrotic ILD.
CI  - (c) Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and 
      permissions. Published by BMJ.
FAU - Guler, Sabina Anna
AU  - Guler SA
AD  - Department of Pulmonary Medicine, Inselspital, Bern University Hospital, 
      University of Bern, Bern, Switzerland sabina.a.guler@gmail.com.
FAU - Hur, Seo Am
AU  - Hur SA
AD  - Department of Medicine, University of British Columbia, Vancouver, British 
      Columbia, Canada.
FAU - Stickland, Michael K
AU  - Stickland MK
AD  - Division of Pulmonary Medicine, University of Alberta, Edmonton, Alberta, Canada.
FAU - Brun, Patrick
AU  - Brun P
AD  - Bern Rehabilitation Center, Heiligenschwendi, Bern, Switzerland.
FAU - Bovet, Luc
AU  - Bovet L
AUID- ORCID: 0000-0001-5918-7998
AD  - Bern Rehabilitation Center, Heiligenschwendi, Bern, Switzerland.
FAU - Holland, Anne E
AU  - Holland AE
AD  - Department of Physiotherapy, Monash University and Alfred Health, Melbourne, 
      Victoria, Australia.
FAU - Bondarenko, Janet
AU  - Bondarenko J
AD  - Department of Physiotherapy, Monash University and Alfred Health, Melbourne, 
      Victoria, Australia.
FAU - Hambly, Nathan
AU  - Hambly N
AD  - Department of Medicine, McMaster University, Firestone Institute for Respiratory 
      Health, Hamilton, Ontario, Canada.
FAU - Wald, Joshua
AU  - Wald J
AD  - Department of Medicine, McMaster University, Firestone Institute for Respiratory 
      Health, Hamilton, Ontario, Canada.
FAU - Makhdami, Nima
AU  - Makhdami N
AD  - Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
FAU - Kreuter, Michael
AU  - Kreuter M
AD  - Center for interstitial and rare lung diseases, Thoraxklinik, University of 
      Heidelberg and German Center for Lung Research, Heidelberg, Germany.
FAU - Gloeckl, Rainer
AU  - Gloeckl R
AD  - Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener 
      Land, Schoenau am Koenigssee, Germany.
FAU - Jarosch, Inga
AU  - Jarosch I
AD  - Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener 
      Land, Schoenau am Koenigssee, Germany.
FAU - Tan, Benjamin
AU  - Tan B
AD  - Department of Medicine, University of British Columbia, Vancouver, British 
      Columbia, Canada.
FAU - Johannson, Kerri A
AU  - Johannson KA
AUID- ORCID: 0000-0003-1205-5511
AD  - Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
FAU - McBride, S Ainslie
AU  - McBride SA
AD  - Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
FAU - De Boer, Kaissa
AU  - De Boer K
AD  - Division of Pulmonary, Allergy and Critical Care Medicine, Department of 
      Medicine, Stanford University, Stanford, California, USA.
FAU - Sandoz, Jacqueline S
AU  - Sandoz JS
AD  - Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
FAU - Sun, Kelly
AU  - Sun K
AD  - Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
FAU - Assayag, Deborah
AU  - Assayag D
AD  - Department of Medicine, McGill University, Montreal, Quebec, Canada.
FAU - Bhatt, Surya P
AU  - Bhatt SP
AUID- ORCID: 0000-0002-8418-4497
AD  - Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama 
      At Birmingham, Birmingham, Alabama, USA.
FAU - Morisset, Julie
AU  - Morisset J
AD  - Departement de Medecine, Centre Hospitalier de l'Universite de Montreal, 
      Montreal, Quebec, Canada.
FAU - Ferraro, Vincent
AU  - Ferraro V
AD  - Departement de Medecine, Centre Hospitalier de l'Universite de Montreal, 
      Montreal, Quebec, Canada.
FAU - Garvey, Chris
AU  - Garvey C
AD  - Pulmonary Rehabilitation and Sleep Disorders Center, University of California San 
      Francisco, San Francisco, California, USA.
FAU - Camp, Pat G
AU  - Camp PG
AD  - Department of Physical Therapy, University of British Columbia, Vancouver, 
      British Columbia, Canada.
AD  - Centre for Heart Lung Innovation, University of British Columbia, Vancouver, 
      British Columbia, Canada.
FAU - Ryerson, Christopher J
AU  - Ryerson CJ
AD  - Department of Medicine, University of British Columbia, Vancouver, British 
      Columbia, Canada.
AD  - Centre for Heart Lung Innovation, University of British Columbia, Vancouver, 
      British Columbia, Canada.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
DEP - 20210830
PL  - England
TA  - Thorax
JT  - Thorax
JID - 0417353
SB  - IM
MH  - Cohort Studies
MH  - Exercise Tolerance
MH  - Female
MH  - Humans
MH  - Inpatients
MH  - *Lung Diseases, Interstitial/rehabilitation
MH  - Male
MH  - *Outpatients
MH  - Retrospective Studies
OTO - NOTNLM
OT  - exercise
OT  - idiopathic pulmonary fibrosis
OT  - interstitial fibrosis
OT  - pulmonary rehabilitation
COIS- Competing interests: None declared.
EDAT- 2021/09/01 06:00
MHDA- 2022/05/20 06:00
CRDT- 2021/08/31 05:56
PHST- 2021/03/27 00:00 [received]
PHST- 2021/08/10 00:00 [accepted]
PHST- 2021/09/01 06:00 [pubmed]
PHST- 2022/05/20 06:00 [medline]
PHST- 2021/08/31 05:56 [entrez]
AID - thoraxjnl-2021-217361 [pii]
AID - 10.1136/thoraxjnl-2021-217361 [doi]
PST - ppublish
SO  - Thorax. 2022 Jun;77(6):589-595. doi: 10.1136/thoraxjnl-2021-217361. Epub 2021 Aug 
      30.