Supervised early PR versus usual care for patients with acute exacerbation of COPD | |||||
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Outcome Timeframe | Study results and measurements | Absolute effect estimates | Certainty in the effects estimates (Quality of evidence) | Plain text summary | |
Usual care | Early PR | ||||
Mortality End of treatment Critical | Relative risk 0.58 (CI 95% 0.35–0.98) Based on data from 319 patients (4 studies) | 173 per 1.000 | 100 per 1.000 | Moderate Due to serious risk of biasa | Early pulmonary rehabilitation probably decreases mortality at the end of treatment |
Difference: 73 fewer per 1.000 (CI 95% 112 fewer - 3 fewer) | |||||
Mortality Longest follow-up Critical | Relative risk 0.55 (CI 95% 0.12–2.57) Based on data from 127 patients (3 studies) | 63 per 1.000 | 35 per 1.000 | Low Due to serious risk of biasand serious risk of imprecisiona,b | Early pulmonary rehabilitation may decrease mortality slightly at the longest follow-up |
Difference: 28 fewer per 1.000 (CI 95% 55 fewer - 99 more) | |||||
Days in hospital End of treatment Important | Measured by: Days Lower is better Based on data from 180 patients (1 study) | 0.86 (mean) | 4.59 (mean) | Moderate Due to serious imprecisionc | Early pulmonary rehabilitation probably decreases days in hospital at the end of treatment |
Difference: MD 4.27 lower (CI 95% 6.85 lower - 1.69 lower) | |||||
Days in hospital Longest follow-up Important | Â | Â | Â | No studies were found that looked at number of days in hospital at the longest follow-up | |
Readmission due to exacerbation End of treatment Important | Â | Â | Â | No studies were found that looked at readmission to hospital due to exacerbation at the end of treatment | |
Readmission due to exacerbation Longest follow-up Important | Rate ratio 0.47 (CI 95% 0.29–0.75) Based on data from 365 patients (6 studies) |  | Moderate Due to serious risk of biasa,d | Early pulmonary rehabilitation probably decreases readmission to hospital due to exacerbation at the longest follow-up | |
Health-related quality of life End of treatment Important | Measured by: SGRQ Lower is better Based on data from 86 patients (2 studies) | Difference: MD 19.43 lower (CI 95% 29.09 lower - 9.77 lower) | Low Due to serious risk of bias and serious risk of imprecisiona,c | Early pulmonary rehabilitation may improve health-related quality of life at the end of treatment | |
Health-related quality of life Longest follow-up Important | Measured by: SGRQ Lower is better Based on data from 323 patients (4 studies) | Difference: MD 8.74 lower (CI 95% 12.02 lower - 5.45 lower) | Moderate Due to serious risk of biasa,d | Early pulmonary rehabilitation probably improves health-related quality of life at the longest follow-up | |
Exercise capacity End of treatment Important | Measured by: SWT (meters) Higher is better Based on data from 95 patients (3 studies) | Difference: MD 54.7 more (CI 95% 30.83 more - 78.57 more) | Moderate Due to serious risk of biasa,d | Early pulmonary rehabilitation probably increases exercise capacity at the end of treatment | |
Exercise capacity End of treatment Important | Measured by: 6MWT (meters) Higher is better Based on data from 274 patients (5 studies | Difference: MD 76.89 more (CI 95% 21.34 more - 132.45 more) | Low Due to serious risk of bias and serious inconsistencya,d,e | Early pulmonary rehabilitation probably increases exercise capacity at the end of treatment | |
Exercise capacity Longest follow-up Important | Measured by: SWT (meters) Higher is better Based on data from 2017 patients (3 studies) | Difference: MD 90.27 higher (CI 95% 69.53 lower - 250.08 higher) | Low Due to serious risk of bias and serious inconsistency leading to serious imprecisiona,b,d,e | Early pulmonary rehabilitation may increase exercise capacity at the longest follow-up | |
Dropout rate End of treatment Important | Relative risk 0.99 (CI 95% 0.71–1.39) Based on data from 440 patients (8 studies) | 217 per 1.000 | 215 per 1.000 | Moderate Due to serious risk of biasa,d | Early pulmonary rehabilitation probably has little impact on the dropout rate at the end of treatment |
Difference: 2 fewer per 1.000 (CI 95% 63 fewer - 85 more) | |||||
Dropout rate Longest follow-up Important | Relative risk 1.05 (CI 95% 0.6–1.85) Based on data from 181 patients (3 studies) | 202 per 1.000 | 212 per 1.000 | Moderate Due to serious risk of biasa,d | Early pulmonary rehabilitation probably has little impact on dropout at the longest follow-up |
Difference: 10 more per 1.000 (CI 95% 81 fewer - 172 more) | |||||
Falls Longest follow-up Important | Â | Â | Â | No studies were found that looked at falls at the longest follow-up | |
Activities of daily living End of treatment Important | Â | Â | Â | No studies were found that looked at activities of daily living at the end of treatment | |
Activities of daily living Longest-follow-up Important | Â | Â | Â | No studies were found that looked at activities of daily living at the longest follow-up |