Related Experiment Video
Updated: Jul 7, 2026
08:17
Generation of a Chronic Obstructive Pulmonary Disease Model in Mice by Repeated Ozone Exposure
Published on: August 25, 2017
A new staging strategy for chronic obstructive pulmonary disease.
Martin R Miller1, Ole F Pedersen, Asger Dirksen
1Department of Medicine, University Hospital Birmingham NHS Trust, Birmingham, UK. martin.miller@uhb.nhs.uk
International Journal of Chronic Obstructive Pulmonary Disease
|February 14, 2008
Summary
For chronic obstructive pulmonary disease (COPD) survival, FEV1/height squared (FEV1/ht2) is a superior predictor compared to FEV1 percent predicted (FEV1PP). This improved staging method offers better patient stratification than the current GOLD guidelines.
Area of Science:
- Pulmonary Medicine
- Respiratory Health
- Clinical Epidemiology
Background:
- The optimal method for assessing lung function impairment in chronic obstructive pulmonary disease (COPD) remains under investigation.
- Current staging systems may not accurately reflect survival outcomes in COPD patients.
Purpose of the Study:
- To compare the efficacy of forced expiratory volume in 1 second (FEV1) percent predicted (FEV1PP) versus FEV1 divided by height squared (FEV1/ht2) in predicting survival among COPD patients.
- To evaluate a novel staging system based on FEV1/ht2 against the established Global Initiative for Obstructive Lung Disease (GOLD) staging.
Main Methods:
- A cohort of 1095 COPD patients was followed for 15 years.
- Forced expiratory volume in 1 second (FEV1), FEV1PP, and FEV1/ht2 measurements were recorded post-bronchodilator.
- Survival prediction models were developed, and a new staging system using FEV1/ht2 was compared to GOLD staging.
Main Results:
- FEV1/ht2 demonstrated superior univariate predictive power for survival in COPD compared to FEV1 and FEV1PP.
- The optimal multivariate model for survival prediction incorporated FEV1/ht2, age, and sex.
- The FEV1/ht2 staging system provided more coherent survival stratification than the GOLD staging system, with GOLD misclassifying 51% of subjects.
Conclusions:
- The Global Initiative for Obstructive Lung Disease (GOLD) criteria, relying on FEV1PP, do not optimally stage COPD patients concerning survival.
- Utilizing FEV1/ht2 offers an improved method for staging COPD severity and predicting survival.
- Alternative staging strategies, such as FEV1/ht2, should be considered for clinical trials and patient management guidelines in COPD.
Related Concept Videos
01:29Chronic Obstructive Pulmonary Disease-V: Management
Managing Chronic Obstructive Pulmonary Disease (COPD) involves a multifaceted approach to reduce symptoms, prevent exacerbations, improve overall health status, and slow disease progression. Key strategies include lifestyle modifications, pharmacotherapy, supportive therapies, and, in some cases, surgery. Here is an overview of the primary COPD management strategies:
Smoking Cessation
Smoking Cessation
01:26COPD: Management Using Bronchodilators and Corticosteroids
Chronic obstructive pulmonary isease (COPD) involves a group of progressive lung disorders characterized by persistent airflow limitation and chronic respiratory symptoms. Asthma-COPD Overlap Syndrome (ACOS), encompassing features of both asthma and Chronic obstructive pulmonary disease (COPD), is a group of progressive lung disorders that includes chronic bronchitis, emphysema, and refractory (non-reversible) asthma. ACOS leads to complex clinical presentations that combine the inflammatory...
01:20Chronic Obstructive Pulmonary Disease-I: Introduction
Chronic Obstructive Pulmonary Disease (COPD) is a long-lasting respiratory condition requiring continuous attention and care. It is a progressive lung disease that leads to breathing challenges due to airflow obstruction. It manifests as persistent respiratory symptoms and restricted airflow resulting from abnormalities in the airways and alveoli, usually due to long-term exposure to harmful particles or gases. COPD mainly consists of two primary conditions: emphysema and chronic bronchitis.
01:30Chronic Obstructive Pulmonary Disease-V: Nursing Management
Nursing management of Chronic Obstructive Pulmonary Disease (COPD) is crucial for providing thorough care and support to patients. Nurses play an integral role in this process through detailed assessment, careful planning, targeted interventions, and ongoing evaluation. Here's an overview of the critical steps in nursing management for COPD.
Assessment
Assessment
01:24Chronic Obstructive Pulmonary Disease
COPD is defined as a heterogeneous lung condition marked by persistent respiratory symptoms such as dyspnea, cough, and sputum production, caused by abnormalities in the airways that cause airflow obstruction.
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...
01:24Chronic Obstructive Pulmonary Disease III: Chronic Bronchitis Features
Chronic bronchitis is a key phenotype of chronic obstructive pulmonary disease (COPD), characterized by airway-centered inflammation and mucus overproduction. It develops from long-term exposure to harmful particles or gases, most commonly cigarette smoke, which triggers a persistent inflammatory response.Cellular and Structural ChangesInflammation initially affects the large bronchi and later the smaller airways, with infiltration by immune cells, including neutrophils, macrophages, and...