Functional status and survival following pulmonary rehabilitation

Background: Functional exercise capacity has been shown to be a strong pred ictor of survival following pulmonary rehabilitation. This study evaluated whether questionnaire-rated functional status is also predictive of surviva l. Patients and methods: Following pulmonary rehabilitation, patients with adv anced chronic lung disease were evaluated for survival, 6-min walk distance , and questionnaire-rated functional status. The latter was measured using the pulmonary functional status scale, which has subscores of functional ac tivities, psychological status, and dyspnea. Information on survival was av ailable on 149 patients. Results: The mean age was 69 years, and 45% of patients were male. Eighty-n ine percent had a diagnosis of COPD, and their FEV1 was 37 +/- 18% of predi cted. Ninety-one (61%) were married. The 3-year survival for the group was 85%. Age, gender, body mass index, and primary diagnosis were not related t o survival. Variables strongly associated with increased survival following pulmonary rehabilitation included a higher postrehabilitation Functional A ctivities score, a longer postrehabilitation 6-min walk distance, and being married (vs widowed, single, or divorced). Disease severity variables asso ciated with survival included an initial referral to outpatient pulmonary r ehabilitation, no supplemental oxygen requirement, and a higher percent-pre dicted FEV1. Conclusion: Indicators of functional status are strong predictors of surviv al in patients with advanced lung disease.