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Published ahead of print on December 10, 2004, doi:10.1164/rccm.200407-867OC

Am. J. Respir. Crit. Care Med., Volume 171, Number 6, March 2005, 591-597

A more recent version of this article appeared on March 15, 2005
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Submitted on July 12, 2004
Accepted on December 6, 2004

The Inspiratory to Total Lung Capacity Ratio Predicts Mortality in Patients with COPD

Ciro Casanova1*, Claudia Cote2, Juan P de Torres1, Armando Aguirre-Jaime1, Jose M Marin3, Victor Pinto-Plata4, and Bartolome R Celli4

1 Respiratory Research Institute, Hospital Universitario N.S. de Candelaria, Santa Cruz de Tenerife, Spain, 2 Pulmonary Department, Bay Pines VA Medical Center, St. Petersburg, FL, USA, 3 Pulmonary Department, Hospital Miguel Servet, Zaragoza, Spain, 4 Pulmonary and Critical Care Department, Caritas - St Elizabeth's Medical Center, Boston, MA, USA

* To whom correspondence should be addressed. E-mail: ccasanova{at}canarias.org.

Static lung hyperinflation (LH) has important clinical consequences in patients with chronic obstructive pulmonary disease (COPD). We analysed the power of LH as measured by the inspiratory capacity to total lung capacity ratio (IC/TLC) to predict mortality in a cohort of 689 patients with COPD (95% males; FEV1 1.17 L) with a mean follow up of 34 months. We also compared the predictive value of IC/TLC with that of BODE. Subjects who died (183; 27%) were older , had lower body mass index (BMI), less FEV1, lower IC/TLC ratio, walked less in the six minute walking distance (6MWD), had more dyspnea, BODE index and co-morbidity (p<0.001). Using logistic regression analysis IC/TLC was a good and independent predictor of all-cause and respiratory mortality. Using ROC type II curves, IC/TLC compared favourably to the FEV1 and predicted mortality independently of BODE . We conclude that IC/TLC is an independent risk factor for mortality in subjects with COPD. We propose that this ratio be considered in the assessment of patients with COPD.
Key words: COPD; inspiratory capacity; outcomes.




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