Predictors of mortality in patients with stable COPD.
OBJECTIVE
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.


METHODS
Five-year prospective cohort study.


METHODS
Five outpatient clinics of a teaching hospital.


METHODS
Six hundred stable COPD patients recruited consecutively.


METHODS
The variables were age, FEV(1%), 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
FEV(1%)(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, FEV(1%) 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.
Esteban
Cristóbal
C
Pneumology Department, Galdakao, Bizkaia, Spain. cristobal_esteban@yahoo.es
Quintana
José M
JM
Aburto
Myriam
M
Moraza
Javier
J
Egurrola
Mikel
M
España
Pedro Pablo
PP
Pérez-Izquierdo
Julio
J
Capelastegui
Alberto
A
D000203:Activities of Daily Living; D000368:Aged; D004417:Dyspnea / Q000401:mortality; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality*; D011788:Quality of Life; D012306:Risk; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology; D016019:Survival Analysis
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