Table 5.
Multivariable Association of 6 Month Physical Measures with 12 Month Patient-Centered Outcomes
| Alive between 6 and 12 montha Odds Ratio (95% CI) | No Hospitalization between 6 and 12 monthb Odds Ratio (95% CI) | Alive at home 12 monthc Odds Ratio (95% CI) | SF-36 PCS 12 month Beta (95% CI) | EQ-5D Utility 12 month Beta (95% CI) | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| 6 Month Physical Measures | ICAP | ALTOS | ICAP | ALTOS | ICAP | ALTOS | ICAP | ALTOS | ICAP | ALTOS |
| N=99 | N=134 | N=81 | N=125 | N=94 | N=133 | N=90 | N=124 | N=91 | N=125 | |
| Body Structure & Function | ||||||||||
| FEV1, each 10% predicted | 2.47 (0.90,6.81) | 0.50 (0.23,1.08) | 0.76 (0.54,1.05) | 1.26 (0.97,1.63) | 2.25 (1.10,4.59)* | 0.63 (0.41,0.97)* | 0.39 (−0.71,1.49) | 0.60 (−0.49,1.70) | −0.69 (−2.81,1.42) | 0.17 (−1.90,2.24) |
| % muscle area, each 10% | 0.64 (0.11,3.85) | 1.25 (0.75,2.09) | 0.77 (0.50,1.20) | 0.92 (0.69,1.22) | 0.41 (0.12,1.42) | 1.07 (0.77,1.48) | 1.56 (−0.01,3.14) | −0.99 (−2.14,0.15) | 2.36 (−0.67,5.39) | −1.84 (−4.01,0.33) |
| MIP, each 10% predicted | 1.21 (0.58,2.51) | 1.35 (0.92,1.98) | 1.01 (0.85,1.20) | 0.93 (0.79,1.09) | 0.85 (0.57,1.29) | 1.19 (0.95,1.49) | −0.14 (−0.75,0.47) | 0.35 (−0.34,1.04) | −0.52 (−1.69,0.66) | 0.75 (−0.56,2.05) |
| MMT, each 10% max MRC score | 0.56 (0.11,2.89) | 0.48 (0.06,3.56) | 0.96 (0.44,2.10) | 1.06 (0.51,2.24) | 1.01 (0.29,3.50) | 1.54 (0.61,3.87) | 2.25 (−0.19,4.70) | 2.25 (−0.87,5.36) | −1.41 (−6.07,3.25) | 9.03 (3.13,14.93)** |
| Grip strength, each 10% predicted | 0.96 (0.51,1.83) | 0.93 (0.61,1.43) | 1.36 (0.98,1.88) | 0.93 (0.76,1.15) | 1.04 (0.65,1.68) | 0.94 (0.70,1.26) | −0.96 (−1.88,−0.03) | −0.79 (−1.63,0.05) | −2.05 (−3.84,−0.27) | −0.97 (−2.56,0.62) |
| Activity | ||||||||||
| 6 min walk, each 10% predicted | 0.56 (0.22,1.46) | 1.31 (0.71,2.39) | 1.36 (0.98,1.87) | 1.11 (0.81,1.51) | 0.69 (0.35,1.36) | 1.21 (0.85,1.71) | 1.73 (0.64,2.83)** | 1.13 (−0.06,2.33) | 2.31 (0.20,4.42)* | 0.51 (−1.73,2.75) |
| 4 meter walk speed (per 0.11 m/s) | -- | 0.78 (0.54,1.13) | -- | 1.22 (0.94,1.58) | -- | 0.81 (0.64,1.03) | -- | 0.70 (−0.12,1.52) | -- | 0.79 (−0.77,2.35) |
| Participation | ||||||||||
| No. ADL dependencies (ICAP only) | 0.62 (0.15,2.54) | -- | 0.89 (0.50,1.57) | -- | 0.83 (0.25,2.74) | -- | 1.05 (−1.35,3.44) | -- | 0.65 (−3.96,5.25) | -- |
| No. IADL dependencies (ICAP only) | 0.41 (0.19,0.91)* | -- | 1.50 (1.02,2.20)* | -- | 0.54 (0.31,0.96)* | -- | −1.32 (−2.40,−0.24)* | -- | −2.89 (−4.96,−0.81)** | -- |
| FPI-Total, per 0.20 unit (ALTOS only) | -- | 1.05 (0.71,1.55) | -- | 1.04 (0.86,1.25) | -- | 1.17 (0.90,1.53) | -- | 1.51 (0.72,2.29)** | -- | 2.00 (0.52,3.49)** |
| Model Fit; Variance Explained | AUC=0.95 | AUC=0.83 | AUC=0.74 | AUC=0.71 | AUC=0.91 | AUC=0.78 | R2=0.27 | R2=0.34 | R2=0.15 | R2=0.23 |
Abbreviations: FEV1: forced expiratory volume in 1 second; MIP: maximal inspiratory pressure; MMT: manual muscle testing; MRC: Medical Research Council; 6MWT: six minute walk test; 4-m: 4-meter; m/sec: meter per second; ADL: activities of daily living; IADL: instrumental activities of daily living; FPI: Functional Performance Inventory; SF-36 PCS: Medical Outcomes Short-Form 36 Physical Component Score; EQ-5D: Euro-QOL.
Alive between 6 and 12M (Yes=1, 0=No, ICAP: 1, n=95, 96%; 0, n=4, 4%; ALTOS:1, n=129, 96%; 0, n=5, 4%);
No Hospitalization between 6 and 12M (Yes=1, 0=No, ICAP: 1, n=59, 73%; 0, n=22, 27%; ALTOS: 1, n=98, 78%; 0, n=27, 22%);
Alive at home outcome for 12m (Yes=1, 0=No; ICAP: 1, n=88, 94%, 0, n=6, 6%; ALTOS: 1, n=120, 90%; 0, n=13, 10%);
FEV1 at 6M for ICAP has missing values imputed using 3M values; No imputation of FEV1 values were performed for ALTOS.
Model fit is based on pseudo R2 for alive at home and R2 for SF-36 PCS and EQ5D Utility.
p≤0.05;
p≤ 0.01;
= Measure not available in dataset;.
0.11 m/sec is an estimated MCID for the 4-m gait speed test based on prior study among COPD patients (Reference: Kon et al. Eur Respir J. 2014;43(5):129881305);
0.20 is an estimated MCID for the Functional Performance Inventory. There was no evidence of multi-collinearity (Variance inflation factor ≤ 1.59 for independent variables estimated within each models)