Changes in SPPB during hospital admission for AECOPD

Background: Hospital admission with acute exacerbation of COPD (AECOPD) is associated with significant loss of physical function which may only partially recover. Understanding this inpatient process may help to target interventions. Methods: The Short Physical Performance Battery (SPPB) was measured within 36 hours of admission and repeated up to 24 hours before discharge in patients admitted with AECOPD in an observational study. Other disease related clinical factors were assessed for association with improving SPPB during admission. Results: 26 patients (mean age of 69±10 years) were included. Mean (SD) total SPPB at admission was 4.96 (2.80), at discharge 6.04 (2.88). Overall mean SPPB improved by 1.07 (2.42) (p=0.03) with 17 (65%) patients improving their SPPB score by the minimal clinically important difference of ≥1 during admission. Individual patient SPPB scores for admission and discharge are shown in figure 1. Only lower BMI and Fat Free Mass Index showed a relationship to likelihood of improving SPPB during admission though there was also a trend for raised CRP and neutrophil count. Conclusions: The SPPB improves significantly during hospitalisation for AECOPD however the response appears to be variable between patients. Discharge from hospital does not appear to be contingent on recovered SPPB performance.