% 0期刊文章%义,e % Gorgone, P. %A Vagaggini, B. %A Pagani, M. %A Rossi, G. %A Costa, F. %A Guarriello, V. %A Paggiaro, P. %A Chetta, A. %A de Blasio, F. %A Olivieri, D. %A Fabbri, L.M. %A Clini, E.M. %T Efficacy of standard rehabilitation in COPD outpatients with comorbidities %D 2010 %R 10.1183/09031936.00203809 %J European Respiratory Journal %P 1042-1048 %V 36 %N 5 %X A prospective study was performed to confirm the prevalence pattern of the most frequent co-morbidities and to evaluate whether characteristics of patients, specific comorbidities and increasing number of comorbidities are independently associated with poorer outcomes in a population with complex chronic obstructive pulmonary disease (COPD) submitted for pulmonary rehabilitation (PR). 316 outpatients (mean±sd age 68±7 yrs) were studied. The outcomes recorded were comorbidities and proportion of patients with a pre-defined minimally significant change in exercise tolerance (6-min walk distance (6MWD) +54 m), breathlessness (Medical Research Council (MRC) score -1 point) and quality of life (St George’s Respiratory Questionnaire -4 points). 62% of patients reported comorbidities; systemic hypertension (35%), dyslipidaemia (13%), diabetes (12%) and coronary disease (11%) were the most frequent. Of these patients, >45% improved over the minimum clinically important difference in all the outcomes. In a logistic regression model, baseline 6MWD (OR 0.99, 95% CI 0.98–0.99; p = 0.001), MRC score (OR 12.88, 95% CI 6.89–24.00; p = 0.001) and arterial carbon dioxide tension (OR 1.08, 95% CI 1.00–1.15; p = 0.034) correlated with the proportion of patients who improved 6MWD and MRC, respectively. Presence of osteoporosis reduced the success rate in 6MWD (OR 0.28, 95% CI 0.11–0.70; p = 0.006). A substantial prevalence of comorbidities in COPD outpatients referred for PR was confirmed. Only the individual's disability and the presence of osteoporosis were independently associated with poorer rehabilitation outcomes. %U //www.qdcxjkg.com/content/erj/36/5/1042.full.pdf