Ralf Ewert1, Anne Obst1, Andreas Mühle2, Michael Halank3, Jörg Winkler4, Bernd Trümper5, Gerhard Hoheisel4, Andreas Hoheisel6, Mark Wiersbitzky7, Alexander Heine1, Alexander Maiwald1, Sven Gläser1,8, Beate Stubbe1. 1. Internal Medicine B, Pneumology, University Hospital Greifswald, Greifswald, Germany. 2. Teuchern Specialist Centre, Teuchern, Germany. 3. Internal Medicine, Pneumology, University Hospital Dresden, Dresden, Germany. 4. Medical Practice Leipzig, Leipzig, Germany. 5. Medical Practice Breathing & Sleep Erfurt, Erfurt, Germany. 6. Clinic of Pneumology and Pulmonary Cell Research, University Hospital Basel, Basel, Switzerland. 7. Medical Practice Anklam, Anklam, Germany. 8. Internal Medicine, Pneumology, Vivantes Hospital Berlin, Berlin, Germany.
Abstract
INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is one of the most common chronic diseases associated with high mortality. Previous studies suggested a prognostic role for peak oxygen uptake (VO2peak) assessed during cardiopulmonary exercise testing (CPET) in patients with COPD. However, most of these studies had small sample sizes or short follow-up periods, and despite their relevance, CPET parameters are not included in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) tool for assessment of severity. OBJECTIVES: We therefore aimed to assess the prognostic value of CPET parameters in a large cohort of outpatients with COPD. METHODS: In this retrospective, multicentre cohort study, medical records of patients with COPD who underwent CPET during 2004-2017 were reviewed and demographics, smoking habits, GOLD grade and category, exacerbation frequency, dyspnoea score, lung function measurements, and CPET parameters were documented. Relationships with survival were evaluated using Kaplan-Meier analysis, Cox regression, and receiver operating characteristic (ROC) curves. RESULTS: Of a total of 347 patients, 312 patients were included. Five-year and 10-year survival probability was 75% and 57%, respectively. VO2peak significantly predicted survival (hazard ratio: 0.886 [95% confidence interval: 0.830; 0.946]). The optimal VO2peak threshold for discrimination of 5-year survival was 14.6 mL/kg/min (area under ROC curve: 0.713). Five-year survival in patients with VO2peak <14.6 mL/kg/min versus ≥ 14.6 mL/kg/min was 60% versus 86% in GOLD categories A/B and 64% versus 90% in GOLD categories C/D. CONCLUSIONS: We confirm that VO2peak is a highly significant predictor of survival in COPD patients and recommend the incorporation of VO2peak into the assessment of COPD severity.
INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is one of the most common chronic diseases associated with high mortality. Previous studies suggested a prognostic role for peak oxygen uptake (VO2peak) assessed during cardiopulmonary exercise testing (CPET) in patients with COPD. However, most of these studies had small sample sizes or short follow-up periods, and despite their relevance, CPET parameters are not included in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) tool for assessment of severity. OBJECTIVES: We therefore aimed to assess the prognostic value of CPET parameters in a large cohort of outpatients with COPD. METHODS: In this retrospective, multicentre cohort study, medical records of patients with COPD who underwent CPET during 2004-2017 were reviewed and demographics, smoking habits, GOLD grade and category, exacerbation frequency, dyspnoea score, lung function measurements, and CPET parameters were documented. Relationships with survival were evaluated using Kaplan-Meier analysis, Cox regression, and receiver operating characteristic (ROC) curves. RESULTS: Of a total of 347 patients, 312 patients were included. Five-year and 10-year survival probability was 75% and 57%, respectively. VO2peak significantly predicted survival (hazard ratio: 0.886 [95% confidence interval: 0.830; 0.946]). The optimal VO2peak threshold for discrimination of 5-year survival was 14.6 mL/kg/min (area under ROC curve: 0.713). Five-year survival in patients with VO2peak <14.6 mL/kg/min versus ≥ 14.6 mL/kg/min was 60% versus 86% in GOLD categories A/B and 64% versus 90% in GOLD categories C/D. CONCLUSIONS: We confirm that VO2peak is a highly significant predictor of survival in COPD patients and recommend the incorporation of VO2peak into the assessment of COPD severity.
Authors: C-P Criée; D Berdel; D Heise; P Kardos; D Köhler; W Leupold; H Magnussen; W Marek; R Merget; H Mitfessel; M Rolke; S Sorichter; W Worth; H Wuthe Journal: Pneumologie Date: 2006-09
Authors: Jose M Marin; Inmaculada Alfageme; Pere Almagro; Ciro Casanova; Cristobal Esteban; Juan J Soler-Cataluña; Juan P de Torres; Pablo Martínez-Camblor; Marc Miravitlles; Bartolome R Celli; Joan B Soriano Journal: Eur Respir J Date: 2012-12-06 Impact factor: 16.671
Authors: Renske Meijer; Martijn van Hooff; Nicole E Papen-Botterhuis; Charlotte J L Molenaar; Marta Regis; Thomas Timmers; Lonneke V van de Poll-Franse; Hans H C M Savelberg; Goof Schep Journal: Int J Gen Med Date: 2022-04-05