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Prediction of Severe Exacerbations and Mortality in COPD: the Role of Exacerbation History and Inspiratory Capacity/Total Lung Capacity Ratio

2018Journal article Open access
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dc.contributor.authorCardoso, J
dc.contributor.authorCoelho, R
dc.contributor.authorRocha, C
dc.contributor.authorCoelho, C
dc.contributor.authorSemedo, L
dc.contributor.authorBugalho Almeida, A
dc.date.accessioned2018-08-07T11:26:35Z
dc.date.available2018-08-07T11:26:35Z
dc.date.issued2018
dc.description.abstractBACKGROUND: Severe exacerbations and mortality are major outcomes in COPD, and risk factors for these events are actively searched for. Several predictors of mortality have been identified in COPD. The inspiratory capacity/total lung capacity (IC/TLC) ratio has been shown to be a strong predictor of all cause and respiratory mortality in patients with COPD. The major objectives of this study were to analyze which clinical parameters, including lung volumes, were the best predictors of the 5-year cumulative risk of hospital admissions or death and the 5-year risk of exacerbations, in stable COPD patients. METHODS: This study retrospectively reviewed data from 98 stable COPD patients, consecutively recruited in 2012. Forced expiratory volume in 1 s (FEV1), modified Medical Research Council dyspnea scale, exacerbation history (ExH), Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2011 groups, and lung volumes were reviewed. Five years later, this population was evaluated for cumulative exacerbations, hospital admissions, and mortality. All the population, and GOLD group D separately, were analyzed. RESULTS: The cumulative 5-year combined risk of hospital admission or death was significantly predicted by the ExH and the IC/TLC ratio. Analyzing separately group D, FEV1 was the only predictor of this outcome. The frequency of exacerbations in the previous year was the best predictor of future cumulative 5-year risk of subsequent exacerbations, both for the total population and the GOLD D group. CONCLUSION: ExH and IC/TLC ratio were the best predictors of the most severe outcomes in COPD (admissions or mortality), independently of COPD severity. FEV1 was the only predictor of the cumulative 5-year combined risk of hospital admission or death in the GOLD D group. ExH was the best predictor of 5-year cumulative future risk of exacerbations. Besides FEV1 and ExH, the IC/TLC ratio can be a useful predictor of severe outcomes in COPD.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationInt J Chron Obstruct Pulmon Dis. 2018 Apr 5;13:1105-1113.pt_PT
dc.identifier.doi10.2147/COPD.S155848pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3024
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherDove Medical Presspt_PT
dc.subjectCHLC PNEUpt_PT
dc.subjectDisease Progressionpt_PT
dc.subjectForced Expiratory Volumept_PT
dc.subjectInspiratory Capacitypt_PT
dc.subjectLung/physiopathologypt_PT
dc.subjectLung Volume Measurementspt_PT
dc.subjectPatient Admission
dc.subjectPrognosis
dc.subjectPulmonary Disease, Chronic Obstructive/diagnosis
dc.subjectPulmonary Disease, Chronic Obstructive/mortality
dc.subjectPulmonary Disease, Chronic Obstructive/physiopathology
dc.subjectRetrospective Studies
dc.subjectRisk Factors
dc.subjectSeverity of Illness Index
dc.subjectTime Factors
dc.subjectTotal Lung Capacity
dc.subjectVital Capacity
dc.titlePrediction of Severe Exacerbations and Mortality in COPD: the Role of Exacerbation History and Inspiratory Capacity/Total Lung Capacity Ratiopt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage1113pt_PT
oaire.citation.startPage1105pt_PT
oaire.citation.titleInternational Journal of Chronic Obstructive Pulmonary Diseasept_PT
oaire.citation.volume13pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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