The Application Of ICF In The Clinical Rehabilitation Effect Evaluation Of The COPD Patients

Objectives Evaluate the COPD patients in the department of respiration in China-Japan Union Hospital of Jilin University at two points—in hospital admission and discharge through the ICF,6 minutes’ walk distance and CAT. And collect the clinical common pulmonary function evaluation indexes and blood gas analysis indexes data. Analyze the relevance among ICF scores,6 minutes’ walking distance, CAT scores and above indexes, compare the relationship between the changes of ICF score and the changes of the indexes during hospitalization, in order to evaluate the application value of the general combination of ICF in the evaluation of the clinical rehabilitation effect of COPD patients.Methods 200 cases of COPD patients studied in the department of respiration between May 2016 and June 2015 in China-Japan Union Hospital of Jilin University in Changchun city were as the research object, the patients were evaluated with ICF general combination, 6 minutes’ walking distance and CAT. General demographic data(gender, age, residence, etc.), pulmonary function and blood gas analysis were used to collect the information from the medical records. Use Excel to establish database and compete data entry, and the data used SPSS21..0 for statistical analysis.Variance analysis was used to compare between groups, correlation analysis used Spearman correlation, The clinical value of ICF score for COPD classification was analyzed by using the method of compiling ROC curve.Results(1) At the time of admission, make the different degrees of COPD patients about lung function index FEV1(F=69.816, p<0.05), blood gas analysis index PO2(F=5.525, p<0.05), PCO2(F=7.391, p<0.05), physical activity index 6 minutes walking distance(H=140.564, p<0.05), CAT score(H=176.575, p<0.05) for statistical analysis, the difference is statistical significance.(2) The ICF score difference between patients in the city and the patients not in this city was statistically significant(Z = 0.042, p < 0.05); Different gender, different age groups and different kinds of health care patients of the difference between ICF scores had no statistical significance(p > 0.05).(3) Make the severity of COPD disease as the state variables, severe and extremely severe as the outcome, the admission ICF score ROC curve as the evaluation variables, the area under the curve(AUC) for 0.954, 95%CI, 0.931~0.978, P<0.001.(4) Admission ICF score was negatively correlated with FEV1(rs=-0.678, p<0.05), PO2(rs=-0.315, p<0.05) and 6MWD(rs=-0.730, p<0.05), and PCO2(rs=0.258, p<0.05), CAT score(rs=0.857 p<0.05,) was positively correlated.(5) The admission and discharge of each index were compared, the difference was statistically significant between admission and lung function index FEV1 discharge values(Z=-3.672, p<0.001); blood gas analysis of the difference between the indexes of PO2, PCO2, the discharge values were statistically significant(t=-18.048, p<0.001; t=5.477, p<0.001); physical activity index 6 minutes there are also differences in walking distance between at admission and discharge values(Z=-12.247, p<0.05); CAT score(Z=-12.396, p<0.05) and ICF scores on admission and discharge of two point difference between the scores obtained were statistically significant(Z=-11.922, p<0.05).(6) ICF score at discharge was negatively correlated with FEV1(rs= 0.439, p<0.05), PO2(rs= 0.254, p<0.05), and positively correlated with PCO2(rs =0.231, p<0.05) and CAT score(rs =0.833, p<0.05).(7) ICF difference between admission and discharge was negatively correlated with FEV1(r=-0.315, P<0.05) and 6MWD(r=-0.141, P<0.05), but there was no correlation among ICF score and PO2, PCO2, and CAT difference(P>0.05).Conclusion ICF score along with the change of the disease is in line with other evaluation indexes and clinical commonly used indexes of pulmonary function and blood gas analysis indexes changes with the trend of the disease. The evaluation indexes of admission and discharge were all correlated. The difference was related to the difference of lung function and physical activity index, this can be used as a comprehensive index to judge the condition of the disease. It has good application value in the clinical rehabilitation effect evaluation of COPD.