Predicting risk factors of death in patients with COPD (based on results of a prospective observational study)

Abstract

The study was aimed to reveal predictors of death in patients with chronic obstructive pulmonary disease (COPD) and to create an integral prognostic index of fatal outcome. We have observed 86 patients with COPD during 3 to 5 yrs. Of them, 19 patients died including 15 ones died from COPD and its complications. Poor outcomes were not seen in 39 (45,3 %) of the patients. We have concluded that FEV₁ < 40 % of predictive values, SaO₂ < 90 %, distance walked for 6 min < 300 m, systolic pulmonary artery pressure ≥ 40 mm Hg, thickening of the right ventricular wall ≥ 0.7 cm, the right ventriculum size ≥ 3 cm, relative dilation of the right atrium (index ≤ 0.9), right ventricular diastolic dysfunction, clinical signs of heart failure, and hyperkinetic type of circulation predicted risk of death in COPD patients. The risk of death was higher in patients older 60 yrs suffering from dyspnea longer that 10 yrs, with smoking history more than 40 yrs and ≥ 50 pack years. Thus, risk of death in COPD patients can be defined using a simple integrative index HODEH which is associated with poor outcome being > 9.