Carlos Cabrera López1, Ciro Casanova Macario2, José María Marín Trigo3, Juan P de-Torres4, Rebeca Sicilia Torres5, Jesús María González6, Francesca Polverino7, Miguel Divo7, Víctor Pinto Plata8, Javier Zulueta4, Francisco Javier Callejas9, Bartolomé Celli7. 1. Servicio de Neumología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España. Electronic address: ccablopn@gmail.com. 2. Servicio de Neumología, Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, España. 3. Servicio de Neumología, Hospital Universitario Miguel Servet, Zaragoza, España. 4. Servicio de Neumología, Clínica Universitaria de Navarra, Pamplona, España. 5. Servicio de Neumología, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España. 6. Unidad de Investigación, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, España. 7. Pulmonary and Critical Care Service, Brigham and Women's Hospital, Boston, Massachusetts, Estados Unidos. 8. Pulmonary and Critical Care Division, Baystate Medical Center, Springfield, Massachusetts, Estados Unidos. 9. Complejo Hospitalario Universitario de Albacete, Albacete, España.
Abstract
INTRODUCTION: The Spanish COPD guidelines (GesEPOC) have been recently modified. The aim of this study is to assess this revision and evaluate the prognosis of patients according to the new classification of severity. METHODS: A total of 700 COPD patients (83.9% men) were prospectively followed up for a mean period of 5 years in tertiary hospitals in Spain and the USA. Anthropometric data, lung function tests, dyspnea (according to the mMRC scale), BODE and Charlson index were collected. We calculated mortality at 5 years following the risk criteria proposed by the new GesEPOC. RESULTS: Mean age was 66±9.6 years and mean FEV1% was 59.7±20.2. The proportion of patients in the low-risk group was 40.43%. Patients in the high-risk group had a significantly higher BODE index than those in the low-risk group (2.92±0,66 vs. 0.52±1.91, p<0.001), while the Charlson index score was similar in both groups. Mortality at 60 months was significantly higher in the high-risk group (31.7% vs. 15.5%, p<0.001). Dyspnea and FEV1% were also independent predictors of mortality (p<0.001), and neither was inferior to the risk classification proposed by GesEPOC. CONCLUSIONS: The new severity index proposed by GesEPOC accurately predicts 5-year mortality. However, dyspnea and FEV1% have the same strength in predicting mortality.
INTRODUCTION: The Spanish COPD guidelines (GesEPOC) have been recently modified. The aim of this study is to assess this revision and evaluate the prognosis of patients according to the new classification of severity. METHODS: A total of 700 COPDpatients (83.9% men) were prospectively followed up for a mean period of 5 years in tertiary hospitals in Spain and the USA. Anthropometric data, lung function tests, dyspnea (according to the mMRC scale), BODE and Charlson index were collected. We calculated mortality at 5 years following the risk criteria proposed by the new GesEPOC. RESULTS: Mean age was 66±9.6 years and mean FEV1% was 59.7±20.2. The proportion of patients in the low-risk group was 40.43%. Patients in the high-risk group had a significantly higher BODE index than those in the low-risk group (2.92±0,66 vs. 0.52±1.91, p<0.001), while the Charlson index score was similar in both groups. Mortality at 60 months was significantly higher in the high-risk group (31.7% vs. 15.5%, p<0.001). Dyspnea and FEV1% were also independent predictors of mortality (p<0.001), and neither was inferior to the risk classification proposed by GesEPOC. CONCLUSIONS: The new severity index proposed by GesEPOC accurately predicts 5-year mortality. However, dyspnea and FEV1% have the same strength in predicting mortality.
Authors: Olga Peypoch; Ferran Paüls-Vergés; Miquel Vázquez-Santiago; Jaime Dilme; Jose Romero; Jordi Giner; Vicente Plaza; Jose Roman Escudero; Jose Manuel Soria; Mercedes Camacho; Maria Sabater-Lleal Journal: J Clin Med Date: 2020-04-24 Impact factor: 4.241