Page 232 - Hospital Authority Convention 2017

Service Enhancement Presentations
HOSPITAL AUTHORITY CONVENTION 2017

F8.3 Young HA Investigators Presentations 14:30 Room 421

Survival in Patients with Chronic Obstructive Pulmonary Disease Following Pulmonary Rehabilitation
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Ko WN , Ng HP , Lau WL , Tsui TS , Yeung LN , Mok YW , Yim CW , Ling SO , Poon YN , Kwan HY , Yau PY 2
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Department of Occupational Therapy, Respiratory Medical Department, Kowloon Hospital, Hong Kong
Introduction
Pulmonary Rehabilitation Programme (PRP) is an important component in the management of chronic obstructive pulmonary
diseases (COPD). Established benefits include improvement in exercise performance, reduction in symptoms and healthcare
utilisation. However, survival benefit was uncertain. Data from PRP of Department of Respiratory Medicine (RMD) of Kowloon
Hospital (KH), the first department in Hong Kong that inaugurated PRP, was analysed to fill this knowledge gap. The results
would be useful in identifying patients at risks and facilitating future service revamp.
Objectives
To explore the survival functions of COPD patients recruited in KHPRP from 2003 to 2012; and (2) to identify important
survival predictors of COPD patients.
Methodology
This is a retrospective study that included COPD patients who participated in PRP in KH from 2003 to 2012. Mortality data
and their causes of death were identified from Clinical Management System and Clinical Data Analysis and Reporting
System as on 30 August 2016. Baseline demographic data and PRP-related factors that might predict better survival were
retrieved: gender, use of long term oxygen therapy, lung function (predicted FEV1and FVC), activities of daily living (ADL)
level, Monitored Functional Task Evaluation score (MFTE), Chronic Respiratory Disease Questionnaire scores, and the PRP
completion rate. Median survival was calculated by Kaplan-Meier analysis. Cox-proportional regression model was used to
explore factors that predict better survival. Using the most significant predictors as strata, their respective effects on survival
function were analysed with Kaplan-Meier analysis again.
Results
348 COPD patients participated in PRP in KHRMD. The mean age of this cohort was 72.3, with a median survival of 4.1 years
(95% CI 3.6 – 4.5). About 73% of them died of non-cancer related respiratory causes. The median survival was 4.8 years (95%
CI 3.6 – 6.0) and 3.6 years (95% CI 2.8 – 4.3) for patients aged<72 and aged≥72 respectively. For patients aged<72, ADL was
a significant survival predictor (p=0.035). The median survival for patients with Moser’s ADL score ≥7 and <7 were 5.3years
(95% CI 4.2– 6.3) and 3.1 years (95% CI 1.1– 5.1) respectively. For patients aged≥72, their MFTE score assessed on admission
significantly predicted survival (p<0.001). The median survival for those having MFTE score≥ 17 and <17 were 5.0 years (95%
CI 4.2– 5.7) and 2.2 years (95% CI 1.5 – 2.9) respectively.

Conclusion
The most important predictors for survival are ADL level for younger patients (aged<72) and MFTE score for older patients
(aged>=72) respectively.
Wednesday, 17 May

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