Predictors of Mortality in Patients with Emphysema and Severe Airflow Obstruction

• DOI: 10.1164/rccm.200510-1677oc
• Publication Date: 2006-03-17T01:44:53Z
• Authors: Fernando J. Martinez; Gregory Foster; Jeffrey L. Curtis; Gerard Criner; Gail Weinmann; Alfred Fishman; Malcolm M. DeCamp; Joshua Benditt; Frank Sciurba; Barry Make; Zab Mohsenifar; Philip Diaz; Eric Hoffman; Robert Wise
• Keywords: Adult; Aged, 80 and over; Male; Exercise Tolerance; Age Factors; Oxygen Inhalation Therapy; Middle Aged; Body Mass Index; 3. Good health; Cohort Studies; Residual Volume; Pulmonary Disease, Chronic Obstructive; Dyspnea; Pulmonary Emphysema; Risk Factors; Forced Expiratory Volume; Quality of Life; Humans; Female; Aged; Forecasting

Limited data exist describing risk factors for mortality in patients having predominantly emphysema.A total of 609 with severe emphysema (ages 40-83 yr; 64.2% male) randomized to the medical therapy arm National Emphysema Treatment Trial formed study group. Cox proportional hazards regression analysis was used investigate all-cause mortality. Risk examined included demographics, body mass index, physiologic data, quality life, dyspnea, oxygen utilization, hemoglobin, smoking history, quantitative markers on computed tomography, and a modification recently described multifunctional index (modified BODE).Overall, high seen this cohort (12.7 deaths per 100 person-years; 292 deaths). In multivariate analyses, increasing age (p=0.001), utilization (p=0.04), lower lung capacity % predicted (p=0.05), higher residual volume maximal cardiopulmonary exercise testing workload (p=0.002), greater proportion zone versus upper (p=0.005), upper-to-lower-lung perfusion ratio (p=0.007), modified BODE (p=0.02) were predictive FEV1 significant predictor univariate but not (p=0.21).Although advanced experience mortality, subgroups based age, measures, capacity, distribution identify those at increased death.