Impact of Regular Exercise on Hospitalization in Patients with COPD: Daily Dose

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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

Last week, we reported on findings from a study published in BMJ Open Respiratory Research that examined the risk of all-cause and respiratory emergency department (ED) visits or hospitalization according to the presence or absence of chronic obstructive pulmonary disease (COPD) and the level of physical activity (PA).

The study

Investigators tapped Health Screening Examination data from the National Health Insurance Service-National Sample Cohort, a population-based retrospective cohort that includes a 2.2% representative sample of Korean citizens. This database collects health data regarding major and minor diagnoses using the ICD-10 codes, health examination findings, and drug prescriptions.

The study’s primary exposure was PA, and PA intensity was measured using self-reported questionnaires; the survey included 3 questions on PA frequency and duration during the prior 7 days. The researchers calculated PA levels by assigning ratings of 2.9, 4.0, and 7.0 METs for light-intensity, moderate-intensity, and vigorous-intensity PAs, respectively.

The primary outcomes of interest were all-cause and respiratory ED visits or hospitalizations. The researchers calculated the respective incidence of ED visits or hospitalizations by dividing the number of ED visits or hospitalizations by the sum of the follow-up duration, presented as the rate per 1000 person-years (PY). Lastly, the covariates considered included body mass index (BMI), smoking status, alcohol consumption, and COPD-related comorbidities.

From the database, the researchers created 2 cohorts: the COPD cohort and the non-COPD cohort. The COPD cohort consisted of 3308 participants with at least 1 ICD-10 code for COPD and COPD-related medications within 1 year of health examination. Conversely, the non-COPD cohort consisted of 293 358 participants without ICD-10 codes for COPD.

The findings

Among all participants, the researchers found the median PA level to be 414 METS-min/week (IQR, 87-728). More specifically, they reported that the PA level was significantly lower in the COPD cohort (280 METS-min/week; IQR, 0-609) than in the non-COPD cohort (414 METS-min/week; IQR, 87-728) (P < .001), highlighting the more significant level of sedentary activity in the COPD cohort than in the non-COPD cohort (35.4% vs 24.1%; P < .001).

Authors' comment

"Increasing PA would be important for improving long-term outcomes in patients with COPD in Korea. Confirmative future prospective studies are needed on whether assessing and modifying PA levels could reduce ED visit or hospitalization in COPD."

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