title: Three-year follow-up study of respiratory and systemic manifestations of chronic obstructive pulmonary disease.
abstract: Few studies show patient outcomes over time in chronic obstructive pulmonary disease (COPD). In the present study, we monitored forced expiratory volume in the first second (FEV₁) and other manifestations of the disease over 3 years in 133 COPD patients (69% males, age = 65 ± 9 years, FEV₁ = 59 ± 25%) evaluated at baseline. During follow-up, 15 patients (11%) died and 23 (17%) dropped out. Measurements for 95 (72%) COPD patients alive after 3 years were analyzed. FEV₁, body mass index (BMI), 6-min walking distance (6MWD), Medical Research Council scale (MRC), Saint George's Respiratory Questionnaire (SGRQ), Charlson Comorbidity index, and BODE index were obtained at baseline and after 3 years. At baseline, 17 patients (18%) presented mild, 39% moderate, 19% severe, and 24% very severe COPD. Predicted FEV₁ % and BMI did not change over the period (P > 0.05). FEV₁ in liters [1.25 (0.96-1.72) vs 1.26 (0.88-1.60) L; P < 0.001], 6MWD (438 ± 86 vs 412 ± 100 m; P < 0.001), MRC [1 (1-2) vs 2 (1-3); P = 0.002], Charlson index [3 (3-4) vs 4 (3-5); P = 0.009], BODE index (2.2 ± 1.8 vs 2.6 ± 2.3; P = 0.008), and total SGRQ (42 ± 19 vs 44 ± 19%; P = 0.041) worsened after 3 years compared to baseline measurements. These data show that COPD patients deteriorated during the 3-year follow-up despite the fact that they had only minor modifications in airway obstruction and body composition. They support the need for comprehensive patient assessment to better identify disease progression.
authors.affiliation: Departamento de Clínica Médica, Universidade Estadual Paulista, Botucatu, SP, Brasil. renataferrarifisio@gmail.com
authors.forename: R
authors.initials: R
authors.lastname: Ferrari
authors.forename: S E
authors.initials: SE
authors.lastname: Tanni
authors.forename: M M
authors.initials: MM
authors.lastname: Faganello
authors.forename: L M O
authors.initials: LM
authors.lastname: Caram
authors.forename: P A
authors.initials: PA
authors.lastname: Lucheta
authors.forename: I
authors.initials: I
authors.lastname: Godoy
mesh_terms: D000368:Aged; D015992:Body Mass Index; D018450:Disease Progression; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*; D012720:Severity of Illness Index; D013147:Spirometry