Pulmonary rehabilitation after hospitalisation for COPD exacerbations
In clinical trials, pulmonary rehabilitation lowers the risk for readmission following hospitalisation for chronic obstructive pulmonary disease (COPD) exacerbations. In this retrospective cohort study, researchers evaluated nearly 200,000 Medicare patients hospitalised with COPD across more than 4,000 medical centres to determine if this association holds up in routine practice.
Patients who underwent pulmonary rehabilitation were healthier overall than those who did not. Therefore, the researchers assembled and compared two propensity-matched cohorts, each with 2,700 patients: One group received rehabilitation, and the other did not, but baseline characteristics were well-matched in the two groups.
Patients who initiated pulmonary rehabilitation within 90 days of discharge were significantly less likely to be rehospitalised (for COPD or any other reason) within 1 year. On average, the probability of rehospitalisations was 0.95 per person in the rehabilitation group and 1.15 per person in the no-rehabilitation group. The number of days spent in the hospital per person-year also was lower in those who initiated pulmonary rehabilitation (7.9 vs 11.7 days).
This large study of a diverse patient population verifies the generalisability of prior randomised trial data and highlights the need to encourage pulmonary rehabilitation participation following discharge among patients hospitalised with COPD.