[Chronic expectoration and risk of death in chronic obstructive lung disease].
We wished to determine whether excess COPD-related mortality in subjects with chronic mucus hypersecretion (CMH) could be explained by proneness to pulmonary infection.


METHODS
14,223 subjects of both sexes were followed for 10-12 years. Deaths with COPD as underlying or contributory cause (n = 214) were included and if death occurred in hospital, hospital records were obtained when possible (n = 101). From information regarding increased or purulent mucus, fever, leucocytosis and chest X-ray during hospital admission, death was classified as caused by pulmonary infection (n = 38), not caused by pulmonary infection (n = 51), or unclassifiable (n = 12).


RESULTS
Of subjects reporting CMH, 54% died from pulmonary infection, whereas that was only the case for 28% of subjects without CMH (p < 0.01). Cox regression-analysis showed a strong inverse relationship between ventilatory function and COPD-related mortality. CMH was an independent predictor of death with pulmonary infection implicated (RR:3.5) but not of death without pulmonary infection (RR:0.9).


CONCLUSIONS
COPD-patients with CMH are more likely to die from pulmonary infection than COPD-patients without CMH.
Prescott
E I
EI
Osterbroundersøgelsen, Righospitalet, København.
Lange
P
P
Vestbo
J
J
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D006801:Humans; D008137:Longitudinal Studies; D008173:Lung Diseases, Obstructive / Q000150:complications / Q000401:mortality / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009093:Mucus / Q000378:metabolism*; D011014:Pneumonia / Q000209:etiology / Q000401:mortality; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects