PMID- 36717292 OWN - NLM STAT- MEDLINE DCOM- 20230505 LR - 20230505 IS - 2531-0437 (Electronic) IS - 2531-0429 (Linking) VI - 29 IP - 3 DP - 2023 May-Jun TI - Clusters of individuals recovering from an exacerbation of chronic obstructive pulmonary disease and response to in-hospital pulmonary rehabilitation. PG - 230-239 LID - S2531-0437(23)00006-5 [pii] LID - 10.1016/j.pulmoe.2023.01.002 [doi] AB - INTRODUCTION AND OBJECTIVES: Due to the present low availability of pulmonary rehabilitation (PR) for individuals recovering from a COPD exacerbation (ECOPD), we need admission priority criteria. We tested the hypothesis that these individuals might be clustered according to baseline characteristics to identify subpopulations with different responses to PR. METHODS: Multicentric retrospective analysis of individuals undergone in-hospital PR. Baseline characteristics and outcome measures (six-minute walking test - 6MWT, Medical Research Council scale for dyspnoea -MRC, COPD assessment test -CAT) were used for clustering analysis. RESULTS: Data analysis of 1159 individuals showed that after program, the proportion of individuals reaching the minimal clinically important difference (MCID) was 85.0%, 86.3%, and 65.6% for CAT, MRC, and 6MWT respectively. Three clusters were found (C1-severe: 10.9%; C2-intermediate: 74.4%; C3-mild: 14.7% of cases respectively). Cluster C1-severe showed the worst conditions with the largest post PR improvements in outcome measures; C3-mild showed the least severe baseline conditions, but the smallest improvements. The proportion of participants reaching the MCID in ALL three outcome measures was significantly different among clusters, with C1-severe having the highest proportion of full success (69.0%) as compared to C2-intermediate (48.3%) and C3-mild (37.4%). Participants in C2-intermediate and C1-severe had 1.7- and 4.6-fold increases in the probability to reach the MCID in all three outcomes as compared to those in C3-mild (OR = 1.72, 95% confidence interval [95% CI] = 1.2 - 2.49, p = 0.0035 and OR = 4.57, 95% CI = 2.68 - 7.91, p < 0.0001 respectively). CONCLUSIONS: Clustering analysis can identify subpopulations of individuals recovering from ECOPD associated with different responses to PR. Our results may help in defining priority criteria based on the probability of success of PR. CI - Copyright (c) 2023 Sociedade Portuguesa de Pneumologia. Published by Elsevier Espana, S.L.U. All rights reserved. FAU - Vitacca, M AU - Vitacca M AD - Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, Brescia, Italy. Electronic address: michele.vitacca@icsmaugeri.it. FAU - Malovini, A AU - Malovini A AD - Laboratory of Informatics and Systems Engineering for Clinical Research of the Institute of Pavia, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy. FAU - Spanevello, A AU - Spanevello A AD - Respiratory Rehabilitation of the Institute of Tradate, Istituti Clinici Scientifici Maugeri IRCCS, Varese, Italy; Department of Medicine and Surgery, University of Insubria, Varese, Italy. FAU - Ceriana, P AU - Ceriana P AD - Respiratory Rehabilitation of the Institute of Pavia, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy. FAU - Paneroni, M AU - Paneroni M AD - Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, Brescia, Italy. FAU - Maniscalco, M AU - Maniscalco M AD - Respiratory Rehabilitation of the Institute of Telese, Istituti Clinici Scientifici Maugeri IRCCS, Benevento, Italy. FAU - Balbi, B AU - Balbi B AD - Respiratory Rehabilitation of the Institute of Veruno, Istituti Clinici Scientifici Maugeri IRCCS, Novara, Italy. FAU - Rizzello, L AU - Rizzello L AD - Respiratory Rehabilitation of the Institute of Milano Istituti Clinici Scientifici Maugeri IRCCS, Milano, Italy. FAU - Murgia, R AU - Murgia R AD - Respiratory Rehabilitation of the Institute of Montescano, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy. FAU - Bellazzi, R AU - Bellazzi R AD - Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy; Laboratory of Informatics and Systems Engineering for Clinical Research of the Institute of Pavia, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy. FAU - Ambrosino, N AU - Ambrosino N AD - Respiratory Rehabilitation of the Institute of Montescano, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy. LA - eng PT - Journal Article DEP - 20230129 PL - Spain TA - Pulmonology JT - Pulmonology JID - 101723786 SB - IM MH - Humans MH - Retrospective Studies MH - *Quality of Life MH - Lung MH - *Pulmonary Disease, Chronic Obstructive MH - Hospitals OTO - NOTNLM OT - COPD OT - Disease impact OT - Dyspnoea OT - Exercise capacity OT - Exercise training OT - Rehabilitation COIS- Conflicts of interest Nicolino Ambrosino is the Chief Editor of Pulmonology. The authors declare they have no conflict of interest. EDAT- 2023/01/31 06:00 MHDA- 2023/05/05 06:42 CRDT- 2023/01/30 21:56 PHST- 2022/09/28 00:00 [received] PHST- 2023/01/04 00:00 [revised] PHST- 2023/01/07 00:00 [accepted] PHST- 2023/05/05 06:42 [medline] PHST- 2023/01/31 06:00 [pubmed] PHST- 2023/01/30 21:56 [entrez] AID - S2531-0437(23)00006-5 [pii] AID - 10.1016/j.pulmoe.2023.01.002 [doi] PST - ppublish SO - Pulmonology. 2023 May-Jun;29(3):230-239. doi: 10.1016/j.pulmoe.2023.01.002. Epub 2023 Jan 29.