Inspiratory capacity predicts mortality in patients with chronic obstructive pulmonary disease.
Articolo
Data di Pubblicazione:
2008
Abstract:
Background: Chronic obstructive pulmonary disease (COPD) severity is usually graded
upon the FEV1 reduction and FEV1 has been considered the most important mortality
predictor with age in COPD. Recent studies suggest other factors as more powerfully
related to mortality than FEV1 in COPD patients.
Aim: To assess the impact of inspiratory capacity (IC) on mortality and morbidity in COPD
patients during a 5-year follow-up period.
Methods: We recruited 222 patients with mild-to-moderate COPD from January 1995 to
December 2001 with an average follow-up period of 60 months (range 30–114 months).
Among different respiratory parameters measured in stable conditions FEV1, FEV1/FVC%,
IC and PaO2, PaCO2 and BMI were chosen and their relationships with all-cause and
respiratory mortality and with morbidity were assessed.
Results: All these variables were associated with mortality at the univariate analysis.
However, in a multivariate regression analysis (Cox proportional hazards model) for
all-cause mortality age (year), IC (%pred.) and PaO2 (mmHg) remained the only significant,
independent predictors (HR ¼ 1.056, 95%CI: 1.023–1.091; HR ¼ 0.981, 95%CI:
0.965–0.998; HR ¼ 0.948, 95%CI: 0.919–0.979, respectively). According to the same
analysis, IC (%pred.) and PaO2 (mmHg) were significant independent predictors for
respiratory mortality (HR ¼ 0.967, 95%CI: 0.938–0.997; HR ¼ 0.919, 95%CI: 0.873–0.969)
together with FEV1/FVC% and BMI (kg/m2) (HR ¼ 0.967, 95%CI: 0.933–1.022; HR ¼ 0.891,
95%CI: 0.807–0.985, respectively). IC (%pred.), FEV1/FVC%, and PaO2 (mmHg) were also
significantly related to morbidity, as independent predictors of hospital admissions
because of exacerbations (OR ¼ 0.980, 95%CI: 0.974–0.992; OR ¼ 0.943, 95%CI:
0.922–0.987; OR ¼ 0.971, 95%CI: 0.954–0.996, respectively). Conclusion: IC (%pred.) is a powerful functional predictor of all-cause and respiratory
mortality and of exacerbation-related hospital admissions in COPD patients.
upon the FEV1 reduction and FEV1 has been considered the most important mortality
predictor with age in COPD. Recent studies suggest other factors as more powerfully
related to mortality than FEV1 in COPD patients.
Aim: To assess the impact of inspiratory capacity (IC) on mortality and morbidity in COPD
patients during a 5-year follow-up period.
Methods: We recruited 222 patients with mild-to-moderate COPD from January 1995 to
December 2001 with an average follow-up period of 60 months (range 30–114 months).
Among different respiratory parameters measured in stable conditions FEV1, FEV1/FVC%,
IC and PaO2, PaCO2 and BMI were chosen and their relationships with all-cause and
respiratory mortality and with morbidity were assessed.
Results: All these variables were associated with mortality at the univariate analysis.
However, in a multivariate regression analysis (Cox proportional hazards model) for
all-cause mortality age (year), IC (%pred.) and PaO2 (mmHg) remained the only significant,
independent predictors (HR ¼ 1.056, 95%CI: 1.023–1.091; HR ¼ 0.981, 95%CI:
0.965–0.998; HR ¼ 0.948, 95%CI: 0.919–0.979, respectively). According to the same
analysis, IC (%pred.) and PaO2 (mmHg) were significant independent predictors for
respiratory mortality (HR ¼ 0.967, 95%CI: 0.938–0.997; HR ¼ 0.919, 95%CI: 0.873–0.969)
together with FEV1/FVC% and BMI (kg/m2) (HR ¼ 0.967, 95%CI: 0.933–1.022; HR ¼ 0.891,
95%CI: 0.807–0.985, respectively). IC (%pred.), FEV1/FVC%, and PaO2 (mmHg) were also
significantly related to morbidity, as independent predictors of hospital admissions
because of exacerbations (OR ¼ 0.980, 95%CI: 0.974–0.992; OR ¼ 0.943, 95%CI:
0.922–0.987; OR ¼ 0.971, 95%CI: 0.954–0.996, respectively). Conclusion: IC (%pred.) is a powerful functional predictor of all-cause and respiratory
mortality and of exacerbation-related hospital admissions in COPD patients.
Tipologia CRIS:
1.1 Articolo in rivista
Keywords:
Chronic obstructive pulmonary disease; Inspiratory capacity; Mortality; Morbidity
Elenco autori:
Tantucci, Claudio; Donati, Paolo; Nicosia, Franco; Bertella, Enrica; Redolfi, Stefania; DE VECCHI, Massimiliano; Corda, Luciano; Grassi, Vittorio; Zulli, Roberto
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