Published ahead of print on November 21, 2002, doi:10.1164/rccm.200206-583OC
American Journal of Respiratory and Critical Care Medicine Vol 167. pp. 544-549, (2003)
© 2003 American Thoracic Society
Analysis of the Factors Related to Mortality in Chronic Obstructive Pulmonary Disease
Role of Exercise Capacity and Health Status
Toru Oga,
Koichi Nishimura,
Mitsuhiro Tsukino,
Susumu Sato and
Takashi Hajiro
Respiratory Division, Kyoto-Katsura Hospital; Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto; and Department of Pulmonary Medicine, Kobe Nishi City Hospital, Kobe, Japan
Correspondence and requests for reprints should be addressed to Toru Oga, M.D., Respiratory Division, Kyoto-Katsura Hospital, 17 Yamadahirao, Nishikyo-ku, Kyoto, 615–8256, Japan. E-mail: ogat{at}df7.so-net.ne.jp
In this study, we analyzed the relationships of exercise capacity and health status to mortality in patients with chronic obstructive pulmonary disease (COPD). We recruited 150 male outpatients with stable COPD with a mean postbronchodilator FEV1 at 47.4% of predicted. Their pulmonary function, progressive cycle ergometry, and health status using the Chronic Respiratory Disease Questionnaire, the St. George's Respiratory Questionnaire (SGRQ), and the Breathing Problems Questionnaire were measured at entry. Among 144 patients who were available for the 5-year follow-up, 31 had died. Univariate Cox proportional hazards analysis revealed that the SGRQ total score and the Breathing Problems Questionnaire were significantly correlated with mortality; however, with the Chronic Respiratory Disease Questionnaire, the total score was not significantly correlated. Multivariate Cox proportional hazards analysis revealed that the peak oxygen uptake and the SGRQ total score were both predictive of mortality, independent of FEV1 and age. Stepwise Cox proportional hazards analysis revealed that the peak oxygen uptake was the most significant predictor of mortality. We found that exercise capacity and health status were significantly correlated with mortality, although different health status measures had different abilities to predict mortality. These results will have a potentially great impact on the multidimensional evaluation of disease severity in COPD.
Key Words: chronic obstructive pulmonary disease • mortality • exercise capacity • health status
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