Physical activity level significantly affects the survival of patients with end-stage lung disease on a waiting list for lung transplantation

Surg Today. 2017 Dec;47(12):1526-1532. doi: 10.1007/s00595-017-1542-6. Epub 2017 May 24.

Abstract

Purpose: Our objective was to investigate the factors predicting the survival of patients on the waiting list for lung transplantation (LT) during the waiting period, with a special emphasis on the physical activity level.

Methods: The study included 70 patients with end-stage pulmonary disease who were on the waiting list for LT at Kyoto University Hospital. We examined the association between the baseline characteristics, including the body mass index and body composition, serum albumin, serum C-reactive protein (CRP), steroid administration, physical activity level (calculated by the food frequency questionnaire) and survival during the waiting period using Kaplan-Meier curves and Cox proportional hazard regression models.

Results: A physical activity level of ≤1.2 was correlated with significantly decreased survival (1-year survival: 68 vs. 90.9%, p = 0.0089), with a hazard ratio (HR) of 2.24 (95% confidence interval (CI) 1.22-4.19, p = 0.0001). Hypo-albumin (HR 2.024, 95% CI 1.339-6.009, p = 0.004), a high level of CRP (HR 2.551, CI 1.229-4.892, p = 0.02), and the administration of steroids (HR 2.258, CI 1.907-5.032, p = 0.024) were also significant predictors of survival.

Conclusions: Low levels of physical activity during the waiting period for LT led to decreased survival times among LT candidates.

Keywords: Body mass index; Lung transplantation; Physical activity; Physiotherapy; Sarcopenia.

MeSH terms

  • Adolescent
  • Adult
  • Body Mass Index
  • Exercise / physiology*
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Lung Diseases / mortality*
  • Lung Diseases / physiopathology*
  • Lung Transplantation*
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Severity of Illness Index
  • Survival*
  • Time Factors
  • Waiting Lists / mortality*
  • Young Adult