title: Predictors of Mortality in Patients with COPD and Chronic Respiratory Failure: The Quality-of-Life Evaluation and Survival Study (QuESS): A Three-Year Study.
abstract: Previous studies sought to identify survival or outcome predictors in patients with COPD and chronic respiratory failure, but their findings are inconsistent. We identified mortality-associated factors in a prospective study in 21 centers in 7 countries. Follow-up data were available in 221 patients on home mechanical ventilation and/or long-term oxygen therapy.
  
  
  METHODS
  diagnosis, co-morbidities, medication, oxygen therapy, mechanical ventilation, pulmonary function, arterial blood gases, exercise performance were recorded. Health status was assessed using the COPD-specific SGRQ and the respiratory-failure-specific MRF26 questionnaires. Date and cause of death were recorded in those who died. Overall mortality was 19.5%. The commonest causes of death were related to the underlying respiratory diseases. At baseline, patients who subsequently died were older than survivors (p = 0.03), had a lower forced vital capacity (p = 0.03), a higher use of oxygen at rest (p = 0.003) and a worse health status (SGRQ and MRF26, both p = 0.02). Longitudinal analyses over a follow-up period of 3 years showed higher median survival times in patients with use of oxygen at rest less than 1.75 l/min and with a better health status. In contrast, an increase from baseline levels of 1 liter in O2 flow at rest, 1 unit in SGRQ or MRF26, or 1 year increase in age resulted in an increase of mortality of 68%, 2.4%, 1.3%, and 6%, respectively. In conclusion, the need for oxygen at rest, and health status assessment seems to be the strongest predictors of mortality in COPD patients with chronic respiratory failure.
authors.affiliation: a Division of Pulmonary Disease, Fondazione Salvatore Maugeri , IRCCS, Scientific Institute of Cassano delle Murge (BA), Cassano delle Murge (BA) , Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Carone
authors.affiliation: b Department of Nursing, Division of Interdisciplinary Medicine-Palliative Care , "Grigore T Popa" University of Medicine and Pharmacy-Iasi , Iasi , Romania.
authors.forename: Sabina
authors.initials: S
authors.lastname: Antoniu
authors.affiliation: c Scientific Direction , Fondazione Salvatore Maugeri , IRCCS , Pavia , Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Baiardi
authors.affiliation: d Division of Pulmonary Disease, Medical Center of Rehabilitation , Fondazione Salvatore Maugeri, IRCCS, Marina di Ginosa , Italy.
authors.forename: Vincenzo S
authors.initials: VS
authors.lastname: Digilio
authors.affiliation: e St George's Hospital Medical School, Division of Physiological Medicine , London ; United Kingdom.
authors.forename: Paul W
authors.initials: PW
authors.lastname: Jones
authors.affiliation: f Psychology Unit, Scientific Institute of Tradate (VA), Fondazione Salvatore Maugeri, IRCCS , Scientific Institute of Tradate , Tradate ( VA ), Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bertolotti
mesh_terms: D000368:Aged; D002423:Cause of Death / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D014943:Global Health; D006304:Health Status; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D011379:Prognosis; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality* / Q000503:physiopathology / Q000523:psychology; D011788:Quality of Life; D012131:Respiratory Insufficiency / Q000401:mortality* / Q000503:physiopathology / Q000523:psychology; D013147:Spirometry; D013997:Time Factors
keywords: COPD; chronic; health status; mortality determinants; quality of life; respiratory failure