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  • Title: The effect of airflow limitation on the cause of death in patients with COPD.
    Author: Alfageme I, Reyes N, Merino M, Reina A, Gallego J, Lima J, Palacios Z.
    Journal: Chron Respir Dis; 2010 Aug; 7(3):135-45. PubMed ID: 20688891.
    Abstract:
    COPD is characterized by airflow limitation that is usually progressive. The present study investigated the cause of death and the effect of airflow limitation on all-cause mortality in COPD patients. A prospective cohort of 600 COPD patients were followed for 3 years. Patients in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage 2 (32.7%), GOLD 3 (48.1%), or GOLD 4 (19.1%). Overall, 117 patients died (19.6%). Deaths were due to respiratory failure (29%), cardiovascular disease (25.6%), cancer (17.9%), infection (11%), gastrointestinal disease (9.4%), and other causes (6.7%). According to the Cox regression analysis, the following independent factors were related to mortality: age (years), hazards ratio (HR) 1.046 (confidence interval [CI] 95% 1.021, 1.072); current smoking status, HR 1.535 (CI 95% 1.003, 2.350); cancer, HR 7.172 (CI 95% 4.515, 11.395); cardiovascular disease, HR 2.623 (CI 95% 1.821, 3.778); severe airflow limitation (GOLD 4), HR 2.378 (CI 95% 1.605, 3.525); and highest quartile of acute exacerbations, HR 1.852 (CI 95% 1.236, 2.775). The present study shows that severe airflow limitation, current smoking status, the presence of cardiovascular disease, cancer, and a high frequency of acute exacerbations have an independent negative impact on the prognosis of COPD patients.
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