Coluccia, Maria GabrielaCruz, Joana Patrícia Dos SantosBrusaca, Luiz AugustoKawakami, Débora Mayumi de OliveiraAraujo, Gustavo Henrique GuimarãesKarloh, ManuelaMendes, Renata GonçalvesLorenzo, Valéria Amorim Pires Di2026-04-012026-04-012026-01-08Colucci, M. G., Cruz, J. P. dos S., Brusaca, L. A., de Oliveira Kawakami, D. M., Guimarães Araujo, G. H., Karloh, M., … Pires Di Lorenzo, V. A. (2026). Early Post-Discharge Predictors of Sedentary Behavior Following COPD Exacerbation: An Observational Study. COPD: Journal of Chronic Obstructive Pulmonary Disease, 23(1). https://doi.org/10.1080/15412555.2025.26001301541-2555http://hdl.handle.net/10400.8/16064Article nr. 2600130The authors would like to thank the Universidade Federal de São Carlos (UFSCar), University Hospital of Federal University of São Carlos - SP-Brazil (HU-UFSCar) Brazilian Company of Hospital Services (EBSERH). Joana Cruz acknowledges the support by FCT - Fundação para a Ciência e Tecnologia, I.P. by project reference “UID/05704/2025” and DOI identifier https://doi.org/10.54499/UID/05704/2025.Patients hospitalized due to an exacerbation of chronic obstructive pulmonary disease (ECOPD) often exhibit increased sedentary behavior (SB), which may persist after discharge and negatively affect recovery. However, early determinants of SB during this period remain unclear. To identify the factors at hospital discharge that predict SB 30 days later in patients with ECOPD. This observational longitudinal study included patients hospitalized for ECOPD, assessed during the first week after discharge and reassessed 30 days later. Data collected included sociodemographic information (age, sex, name, telephone number, and address), anthropometric measurements (weight, height, and body mass index [BMI]), clinical history (previous hospitalizations, exacerbations, and smoking status), dyspnea (Medical Research Council scale, mMRC), health status (COPD Assessment Test, CAT), co-morbidities (Charlson Comorbidity Index), and exercise capacity (6-minute walk test, 6MWT). Physical activity and sedentary behavior—including SB, light (LPA), moderate (MPA), and vigorous (VPA) physical activity, step count, and sleep—were measured using a triaxial accelerometer worn for seven consecutive days. Accelerometer data were processed with ActiPASS software, and statistical analyses were performed in RStudio. Stepwise regression analysis was used to identify the discharge variables that could predict SB at 30 days. Forty-four patients (61% female; age 66 ± 8 years; FEV1 53 ± 13%; Charlson 1 [1–2]; hospital stay 5 [3–6] days) were included. At discharge, median mMRC was 3 (2–3), CAT 21 ± 8, 6MWT 274 ± 102 m, steps/day 3,148, SB 619 ± 226 min/day, and LPA 216 min/day. At 30 days, SB was 615 ± 166 min/day. Dyspnea (mMRC) and LPA at discharge explained SB at 30 days (R2 = 0.31, p < 0.001). Higher levels of dyspnea and lower levels of LPA during the first week after discharge are the significant predictors of SB 30 days after hospitalization for ECOPD.engCOPDdisease exacerbationphysical activityphysiotherapysedentary behaviorjournal article10.1080/15412555.2025.26001301541-2563