According to a recent study, it is estimated that by 2030, chronic obstructive pulmonary disease (COPD) will be the third leading cause of death worldwide. Researchers looked to evaluate predictors of mortality in patients with COPD after 9 years.
The study enrolled 133 patients with COPD and assessed participants at baseline by spirometry; pulse oximetry; body mass index (BMI), airway obstruction, dyspnea, and exercise capacity (BODE); and Charlson Comorbidity Index (CCI) score.
These patients had regular follow-up every 6 months for 9 years by medical appointments and telephone contact with the survivors who had stopped outpatient medical follow-up. Of the 133 patients, 19 stopped follow-up and 4 did not have their cause of death identified; therefore, 110 patients were included in the mortality analysis.
At baseline, of 64 patients who died, 7 were classified with mild COPD, 15 with moderate COPD, 12 with severe COPD, and 30 with very severe COPD. Researchers found that the most common cause of death was respiratory causes in 67% of patients who passed away.
The study shed light on multiple factors that increased the risk of mortality for a patient with COPD. Specifically, it was observed that a higher classification in the index of COPD increased the risk of mortality, and BODE class 4 patients had a 15-fold greater risk of mortality compared with class 1 patients.
Likewise, CCI score and the number of exacerbations were equally associated with increased risk of mortality. These results are reinforced by prior studies that had similar findings. In addition, researchers also discovered that patients with a BMI of 21 kg/m2 or less were 2.7 times more at risk of mortality compared with those with a higher BMI. Similar to this finding, a prior meta-analysis showed that individuals with low weight were associated with higher mortality in COPD.
Overall, researchers identified that those with a high BODE index, greater CCI score, higher frequency of exacerbations in the first 3 years, and BMI of 21 kg/m2 or less were at a higher risk of mortality from COPD.
Prudente R, Frano E, Mesquita C, Ferrari R, de Godoy I, Tanni S. Predictors of mortality in patients with COPD after 9 years. Int J Chron Obstruct Pulmon Dis. 2018;13:3389-3398. dovepress.com/predictors-of-mortality-in-patients-with-copd-after-9-years-peer-reviewed-fulltext-article-COPD. Accessed October 26, 2018.