Predictors of mortality in patients with COPD after 9 years

• Published in: International journal of chronic obstructive pulmonary disease Vol. 13; pp. 3389 - 3398
• Main Authors: Prudente, Robson, Franco, Estefânia Aparecida Thomé, Mesquita, Carolina Bonfanti, Ferrari, Renata, de Godoy, Irma, Tanni, Suzana Erico
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01-01-2018; Dove Medical Press Ltd; Dove Medical Press
• Subjects: Aged; Airway management; Airway obstruction; Airway Obstruction - diagnosis; Airway Obstruction - etiology; Analysis; Body Mass Index; Brazil - epidemiology; Chronic obstructive lung disease; Chronic obstructive pulmonary disease; Chronic obstructive pulmonary disease. Disease severity index. Mortality; Classification; Comorbidity; Dyspnea; Dyspnea - diagnosis; Dyspnea - etiology; Exercise Tolerance; Female; Forced Expiratory Volume; Gold; Humans; Male; Medical research; Medical schools; Middle Aged; Morbidity; Mortality; Original Research; Outpatient care facilities; Oximetry - methods; Oxygen therapy; Patient monitoring equipment; Patient outcomes; Physiological aspects; Predictive Value of Tests; Prognosis; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - mortality; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulse oximetry; Severity of Illness Index; Spirometry; Spirometry - methods; Values; Variables; Walk Test - methods; Brazil; United States > US; disease severity index; mortality; COPD
• ISSN: 1178-2005; 1176-9106; 1178-2005
• DOI: 10.2147/COPD.S174665

COPD is one of the leading causes of morbidity and mortality in the world; however, the most varied amounts of clinical and laboratory characteristics acts in different ways in the mortality among over time. Therefore, this study aimed to evaluate the predictors of mortality in patients with COPD after 9 years.
One hundred and thirty-three patients with COPD were assessed at baseline by spirometry, pulse oximetry (SpO
), body composition, intensity of dyspnea, distance walked in the 6-minute walk test (6MWT), and Charlson Comorbidity Index (CCI).
After 9 years, it was not possible to identify the lifetime of 4 patients who died and of 19 patients who stopped follow-up; thus, 110 patients were included in the analysis of predictors of mortality (67% male, 65±9 years old, and FEV
: 52.5 [40%-73%]). Male sex, age, SpO
, Body mass index, airway Obstruction, Dyspnea, and Exercise capacity (BODE) index, and frequency of exacerbations in the first 3 years of follow-up were considered in the model. Patients classified at baseline with BODE class 2 (HR: 2.62, 95% CI: 1.36-5.04;
=0.004), BODE class 3 (HR: 2.54, 95% CI: 1.15-5.61;
=0.02), and BODE class 4 (HR: 15.35, 95% CI: 3.11-75.75;
=0.001) showed increased risk of death compared to those with BODE class 1. The CCI (HR: 1.29, 95% CI: 1.00-1.68;
=0.04) and the number of exacerbations in the first 3 years (HR: 1.32, 95% CI: 1.00-1.76;
=0.04) also showed increased risk of death. By replacing the BODE index for the variables that compose it, those with body mass index ≤21 kg/m
showed increased risk of death compared to those with body mass index (BMI)>21 kg/m
(HR: 2.70, 95% CI: 1.38-5.25;
=0.003).
After 9 years, we identified that those with high BODE index, greater CCI, greater frequency of exacerbations in the first 3 years, and BMI ≤21 kg/m
showed increased risk of death.