The effect of comorbidity severity on pulmonary rehabilitation outcomes in chronic obstructive pulmonary disease patients

Chronic obstructive pulmonary disease (COPD) is not only associated with respiratory system involvement but also with systemic consequences leading to chronic comorbidities. In this study, we aimed to investigate the effect of comorbidity severity on pulmonary rehabilitation (PR) outcomes in COPD patients. We conducted a retrospective cohort study to compare the effectiveness of PR in COPD patients who completed an 8-week PR program. There were at least one comorbid in 120 of 211 patients and we divided them into the groups according to Charlson Comorbidity Index (CCI) scores (1 points, group 1 (n = 54); 2 points, group 2 (n = 41); 3 points, group 3 (n = 25)). We compared 6-minute walk distance (MWD), dyspnea perception, pulmonary function tests, blood gases analysis, quality of life, anxiety, and depression scores which were recorded before and after PR between the groups. Before PR 6-MWD distance was significantly lower in group 2 (p = 0.033). Improvements in 6-MWD, blood gas values, dyspnea perception, quality of life, and anxiety were determined in all groups after PR (p < 0.05). When the gains after PR were compared, there were no significant differences between groups (p > 0.05). COPD patients benefit from PR independent from their comorbidity severity. Comorbidity severity has no effect on PR gains. Therefore, patients with comorbidities should not be excluded from PR programs and encouraged to participate. CLINICAL TRIAL NUMBER: NCT03319108.