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Published ahead of print on November 21, 2002, doi:10.1164/rccm.200206-583OC

Am. J. Respir. Crit. Care Med., Volume 167, Number 4, February 2003, 544-549

A more recent version of this article appeared on February 15, 2003
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Submitted on June 26, 2002
Accepted on December 17, 2002

Analysis of the factors related to mortality in COPD: Role of exercise capacity and health status

Toru Oga1*, Koichi Nishimura1, Mitsuhiro Tsukino2, Susumu Sato2, and Takashi Hajiro3

1 Respiratory Division, Kyoto-Katsura Hospital, Kyoto, Japan, 2 Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan, 3 Pulmonary Medicine, Kobe Nishi City Hospital, Kobe, Japan

* To whom correspondence should be addressed. E-mail: ogat{at}df7.so-net.ne.jp.

In the present 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 mean postbronchodilator forced expiratory volume in one second (FEV1) at 47.4% of predicted. Their pulmonary function, progressive cycle ergometry and health status using the Chronic Respiratory Disease Questionnaire (CRQ), the St. George's Respiratory Questionnaire (SGRQ) and the Breathing Problems Questionnaire (BPQ) were measured at entry. Among 144 patients who were available for 5-year follow-up, 31 had died. Univariate Cox proportional hazards analysis revealed that the SGRQ total score and the BPQ were significantly correlated with mortality; however the CRQ total score was not significantly correlated. Multivariate Cox proportional hazards analysis revealed that peak oxygen uptake (VO2) and SGRQ total score were both predictive of mortality, independent of FEV1 and age. Stepwise Cox proportional hazards analysis revealed that peak VO2 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 multi-dimensional evaluation of disease severity in COPD.
Key words: chronic obstructive pulmonary disease, mortality, exercise capacity, health status




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