SHORT-STAY COMPREHENSIVE INPATIENT PULMONARY REHABILITATION FOR ADVANCED CHRONIC OBSTRUCTIVE PULMONARY-DISEASE

Objective: To evaluate the effectiveness of short-term, comprehensive inpatient pulmonary rehabilitation in severe chronic obstructive pulmo nary disease (CORD). Design: Retrospective analysis of several outcome measures. Setting: Inpatient pulmonary rehabilitation unit. Participa nts: Thirty-eight consecutive adult patients with advanced COPD referr ed to our inpatient pulmonary rehabilitation program between January 1 and December 31, 1994. All but one were referred from acute care hosp itals. The mean forced expiratory volume in 1 second (FEV(1)) was .69L ; 79% required supplemental oxygen. Main Outcome Measures: (1) Dischar ge status; (2) timed walk, with measurements of distance and exertiona l dyspnea; and (3) functional status. Results: All patients were able to be discharged home after a mean length of stay of 9.9 days. The 12- minute walk distance increased by 66%, from 416 +/- 282 feet to 690 +/ - 337 feet (p < .001). Dyspnea during the walk testing also improved: the resting score decreased from 2.87 to .97, the 6-minute score from 7.84 to 3.05, and postwalk score from 8.53 to 3.51 (all p < .001). All patients showed improvement in the Pulmonary Function Status Scale (P FSS), with the functional activities subsection increasing by 39%, the dyspnea score by 65%, and psychosocial score by 35% (all p < .001). C onclusion: Short-term improvement in multiple areas can be accomplishe d with comprehensive pulmonary rehabilitation of short duration. This is particularly relevant to the current health care environment that d ictates shorter in-hospital lengths of stay. (C) 1996 by the American Congress of Rehabilitation Medicine and the American Academy of Physic al Medicine and Rehabilitation