Pınar ERGUN, Dicle KAYMAZ, Neşe DEMİR, İpek CANDEMİR

KOAH’lı hastalarda pulmoner rehabilitasyonun etkinliğini belirlemek için i-BODE indeksinin kullanımı

Giriş: Pulmoner rehabilitasyon (PR)'un, BODE indeksinin iki bileşeni olan egzersiz intoleransı ve dispnenin düzelmesinde kanıtlanmış bir yaklaşımdır. Ancak, PR’nin, BODE indeksinin başka bir bileşen olan solunum fonksiyonuna minimal etkisi olduğu bilinmektedir. PR etkinliğini i-BODE indeksi kullanarak değerlendiren az sayıda çalışma vardır. Amacımız, kronik obstrüktif akciğer hastalığı (KOAH) olan hastalarda PR’nin etkinliğini i-BODE indeksiyle değerlendirmek ve GOLD 2011 kombine değerlendirmesine göre i-BODE indeksindeki değişiklikleri araştırmaktı. Materyal ve Metod: Sekiz haftalık kapsamlı PR programı tamamlayan toplam 228 KOAH tanılı hasta retrospektif çalışmaya dahil edildi. Bulgular: Hastaların yaş ortalaması 63.3 ± 8.6 yıl ve ortalama FEV1 %38.6 ± 16.2 idi. KOAH’ın kombine değerlendirmesine göre 23 hasta grup A, 30 hasta B, 31 hasta C ve 144 hasta D idi. Bazal i-BODE skorları; vücut kompozisyonları, solunum fonksiyonu, dispne, egzersiz kapasitesi, psikolojik durumla ilişkili yaşam kalitesi ve yaş ile korele olarak izlendi. i-BODE indeks skoru PR sonrası %26’lık farkla 4.7 ± 2.2’den 3.5 ± 1.8’e düştü (p< 0.001). Daha semptomatik olan hastalarda (grup B ve D) dispne, yaşam kalitesi ve i-BODE indeksinde anlamlı gelişmeler bulundu. Sonuç: Bu çalışma PR sonrası i-BODE skorlarındaki değişikliklerin dispne, egzersiz kapasitesi ve yaşam kalitesindeki düzelmelerle anlamlı bir şekilde ilişkili olduğunu vurgulamaktadır. i-BODE skoru, PR’nin etkinliğinin BMI veya FEV1 gibi bazı bireysel değişkenlerden daha iyi bir prediktörü olabilir. PR sonrası, semptomatik hastalarda dispne hissi, yaşam kalitesi ve i-BODE indeksinde önemli gelişmeler izlenebilir.

Use of i-BODE index to determine efficacy of pulmonary rehabilitation in COPD patients

Introduction: Pulmonary rehabilitation (PR) is well-proven approach onimproving dyspnea, exercise intolerance which are two components of BODEindex. But, PR is known to have minimal effect on pulmonary function whichis another component of BODE index. There are few studies evaluating PRefficacy by using i-BODE index. Our aim was to evaluate efficacy of PR inpatients with chronic obstructive pulmonary disease (COPD) with i-BODEindex and to investigate changes in i-BODE index according to GOLD 2011combined assessment.Materials and Methods: A total of 228 stable COPD patients who completeda comprehensive 8 week duration PR program were enrolled into thisretrospective study.Results: The patients were with mean age of 63.3 ± 8.6 years and meanFEV1% was 38.6 ± 16.2%. According to combined assessment of COPD, 23patients were group A, 30 patients were B, 31 patients were C and 144patients were D. Baseline i-BODE scores correlated with body compositions,pulmonary function, dyspnea, exercise capacity, psychological status, qualityof life, and age. i-BODE index score decreased from 4.7 ± 2.2 to 3.5 ± 1.8after PR (p< 0.001), improved by 26%. Significant improvements were foundin dyspnea, quality of life and i-BODE index in more symptomatic patients(group B and D).Conclusion: This study highlights that changes in i-BODE scores after PRsignificantly correlated with improvements in dyspnea, exercise capacity andquality of life. i-BODE score could be a better predictor of efficacy of PR thansome individual variables such as BMI or FEV1. Significant improvements indyspnea sensation, quality of life and i-BODE index could be seen symptomaticpatients in after PR.

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