Predictors of Mortality in Patients with Stable COPD

  • Cristóbal Esteban
  • José M. Quintana
  • Myriam Aburto
  • Javier Moraza
  • Mikel Egurrola
  • Pedro Pablo España
  • Julio Pérez-Izquierdo
  • Alberto Capelastegui
Original Article

DOI: 10.1007/s11606-008-0783-x

Cite this article as:
Esteban, C., Quintana, J.M., Aburto, M. et al. J GEN INTERN MED (2008) 23: 1829. doi:10.1007/s11606-008-0783-x

Abstract

OBJECTIVES

To determine which easily available clinical factors are associated with mortality in patients with stable COPD and if health-related quality of life (HRQoL) provides additional information.

DESIGN

Five-year prospective cohort study.

SETTING

Five outpatient clinics of a teaching hospital.

PARTICIPANTS

Six hundred stable COPD patients recruited consecutively.

MEASUREMENTS

The variables were age, FEV1%, dyspnea, previous hospital admissions and emergency department visits for COPD, pack-years of smoking, comorbidities, body mass index, and HRQoL measured by Saint George’s Respiratory Questionnaire (SGRQ), Chronic Respiratory Questionnaire (CRQ), and Short-Form 36 (SF-36). Logistic and Cox regression models were used to assess the influence of these variables on mortality and survival.

RESULTS

FEV1%(OR: 0.62, 95% CI 0.5 to 0.75), dyspnea (OR 1.92, 95% CI 1.2 to 3), age (OR 2.41, 95% CI 1.6 to 3.6), previous hospitalization due to COPD exacerbations (OR 1.53, 1.2 to 2) and lifetime pack-years (OR 1.15, 95% CI 1.1 to 1.2) were independently related to respiratory mortality. Similarly, these factors were independently related to all-cause mortality with dyspnea having the strongest association (OR 1.54, 95% CI 1.1 to 2.2). HRQoL was an independent predictor of respiratory and all-cause mortality only when dyspnea was excluded from the models, except scores on the SGRQ were associated with all-cause mortality with dyspnea in the model.

CONCLUSIONS

Among patients with stable COPD, FEV1% was the main predictor of respiratory mortality and dyspnea of all-cause mortality. In general, HRQoL was not related to mortality when dyspnea was taken into account, and CRQ and SGRQ behaved in similar ways regarding mortality.

KEY WORDS

chronic obstructive pulmonary disease mortality health-related quality of life 

Supplementary material

11606_2008_783_MOESM1_ESM.doc (69 kb)
Online Appendix(DOC 69 kb)

Copyright information

© Society of General Internal Medicine 2008

Authors and Affiliations

  • Cristóbal Esteban
    • 1
    • 3
  • José M. Quintana
    • 2
  • Myriam Aburto
    • 1
  • Javier Moraza
    • 1
  • Mikel Egurrola
    • 1
  • Pedro Pablo España
    • 1
  • Julio Pérez-Izquierdo
    • 1
  • Alberto Capelastegui
    • 1
  1. 1.Pneumology DepartmentGaldakaoSpain
  2. 2.Research UnitHospital Galdakao-Usansolo-CIBER Epidemiología y Salud Pública (CIBERESP)GaldakaoSpain
  3. 3.Servicio de NeumologíaHospital de Galdakao-UsansoloGaldakaoSpain

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