title: Diaphragmatic dysfunction and mortality in patients with COPD.
abstract: OBJECTIVE
  To determine whether COPD patients with diaphragmatic dysfunction present higher risk of mortality than do those without such dysfunction.
  
  
  METHODS
  We evaluated pulmonary function, diaphragm mobility and quality of life, as well as determining the Body mass index, airway Obstruction, Dyspnea, and Exercise capacity (BODE) index, in 42 COPD patients. The patients were allocated to two groups according to the degree to which diaphragm mobility was impaired: low mobility (LM; mobility < 33.99 mm); and high mobility (HM; mobility > 34.00 mm). The BODE index and the quality of life were quantified in both groups. All patients were followed up prospectively for up to 48 months in order to determine the number of deaths resulting from respiratory complications due to COPD.
  
  
  RESULTS
  Of the 42 patients evaluated, 20 were allocated to the LM group, and 22 were allocated to the HM group. There were no significant differences between the groups regarding age, lung hyperinflation or quality of life. However, BODE index values were higher in the LM group than in the HM group (p = 0.01). During the 48-month follow-up period, there were four deaths within the population studied, and all of those deaths occurred in the LM group (15.79%; p = 0.02).
  
  
  CONCLUSIONS
  These findings suggest that COPD patients with diaphragmatic dysfunction, characterized by low diaphragm mobility, have a higher risk of death than do those without such dysfunction.
authors.affiliation: Fisioterapeuta Supervisor de Aprimoramento. Hospital Sírio Libanês, São Paulo, Brasil. wellpsy@yahoo.com.br
authors.forename: Wellington Pereira dos Santos
authors.initials: WP
authors.lastname: Yamaguti
authors.forename: Elaine
authors.initials: E
authors.lastname: Paulin
authors.forename: João Marcos
authors.initials: JM
authors.lastname: Salge
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Chammas
authors.forename: Alberto
authors.initials: A
authors.lastname: Cukier
authors.forename: Celso Ricardo Fernandes de
authors.initials: CR
authors.lastname: Carvalho
mesh_terms: D015992:Body Mass Index; D003964:Diaphragm / Q000503:physiopathology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality* / Q000503:physiopathology; D011788:Quality of Life; D012120:Respiration Disorders / Q000401:mortality* / Q000503:physiopathology; D012307:Risk Factors