Pulmonary rehabilitation improves survival in patients with idiopathic pulmonary fibrosis undergoing lung transplantation

Sci Rep. 2019 Jun 27;9(1):9347. doi: 10.1038/s41598-019-45828-2.

Abstract

This study was conducted to evaluate whether a pulmonary rehabilitation program (PRP) is independently associated with survival in patients with idiopathic pulmonary fibrosis (IPF) undergoing lung transplant (LTx). This quasi-experimental study included 89 patients who underwent LTx due to IPF. Thirty-two completed all 36 sessions in a PRP while on the waiting list for LTx (PRP group), and 53 completed fewer than 36 sessions (controls). Survival after LTx was the main outcome; invasive mechanical ventilation (IMV), length of stay (LOS) in intensive care unit (ICU) and in hospital were secondary outcomes. Kaplan-Meier curves and Cox regression models were used in survival analyses. Cox regression models showed that the PRP group had a reduced 54.0% (hazard ratio = 0.464, 95% confidence interval 0.222-0.970, p = 0.041) risk of death. A lower number of patients in the PRP group required IMV for more than 24 hours after LTx (9.0% vs. 41.6% p = 0.001). This group also spent a mean of 5 days less in the ICU (p = 0.004) and 5 days less in hospital (p = 0.046). In conclusion, PRP PRP completion halved the risk of cumulative mortality in patients with IPF undergoing unilateral LTx.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Idiopathic Pulmonary Fibrosis / mortality
  • Idiopathic Pulmonary Fibrosis / rehabilitation*
  • Idiopathic Pulmonary Fibrosis / surgery*
  • Kaplan-Meier Estimate
  • Lung Transplantation* / methods
  • Male
  • Middle Aged
  • Perioperative Care
  • Prognosis
  • Recovery of Function
  • Rehabilitation / methods
  • Respiration, Artificial
  • Respiratory Function Tests
  • Retrospective Studies
  • Treatment Outcome