Low physical activity, high sedentary time raise risk for bronchiectasis hospitalization

Adults with bronchiectasis and low levels of physical activity or high sedentary behaviors had an increased risk for hospitalization due to exacerbation at 1 year, according to a study published in the European Respiratory Journal.

“It is well known that increased sedentary behavior is associated with worsened health effects, which may differ from those caused by reduced physical activity in daily life, in both healthy subjects and patients with chronic respiratory diseases,” Victoria Alcaraz-Serrano, MD, with the Clinical Foundation for Biomedical Research at the Hospital Clinic of Barcelona, Spain, and colleagues wrote. “We confirmed that patients hospitalized for an exacerbation of bronchiectasis during the 1-year follow-up period presented poor clinical characteristics, higher severity and lower levels of physical activity at baseline ... than those not hospitalized.”

The prospective, observational study included 64 patients with bronchiectasis who received treatment at a tertiary care hospital in Barcelona, Spain, from March 2016 to August 2017. Researchers assessed the patients’ baseline lung function, quality of life, exercise tolerance, bronchiectasis severity and physical activity. Physical activity was recorded over 1 week via a SenseWear (BodyMedia) armband that tracked daily steps and sedentary time. The researchers then evaluated bronchiectasis exacerbation hospitalization and time to first exacerbation after 1-year follow-up.

Fifteen of the 64 patients (23%) were hospitalized for bronchiectasis exacerbation during follow-up. Those hospitalized had poorer baseline outcomes, walked fewer steps per day and were more sedentary compared with those not hospitalized.

Patients who walked 6,290 steps or less per day or spent at least 7.8 hours performing sedentary behaviors per day had greater risk for hospitalization due to exacerbation at 1 year compared with those who walked more than 6,290 daily steps or with less sedentary time (P < .001). Daily sedentary time of 7.8 hours or more was associated with a 5.9-fold increased risk for bronchiectasis exacerbation hospitalization within 1 year (P < .001), according to the results.

According to the researchers, objectively measured sedentary behavior in patients could serve as an independent predictor of bronchiectasis exacerbation hospitalization.

“If this finding is validated in future studies, it may be appropriate to include physical activity and sedentary behavior as an item in severity scores,” the researchers wrote. “Future studies should consider the inclusion of patients with bronchiectasis from other countries and other ethnicities in order to compare and contrast the results reported here. It will also be important to determine whether reducing the time spent in sedentary behavior can significantly lower the percentage of hospitalized patients.”