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Mortality in COPD: causes, risk factors, and prevention
Cristine E Berry1, Robert A Wise
1Johns Hopkins University School of Medicine, Baltimore, MD, USA. cberry4@jhmi.edu
COPD
|September 22, 2010
Summary
Chronic obstructive pulmonary disease (COPD) is a major cause of death, often underestimated. Mortality risk in COPD patients can be predicted by lung function, exercise capacity, and the BODE index, with interventions like smoking cessation improving survival.
Area of Science:
- Pulmonology and Respiratory Medicine
- Public Health and Epidemiology
- Clinical Medicine
Background:
- Chronic obstructive pulmonary disease (COPD) is a significant and growing cause of mortality, frequently underdiagnosed and underreported.
- Causes of death in mild COPD patients often include cancer and cardiovascular disease, shifting to non-malignant respiratory diseases as COPD severity increases.
Purpose of the Study:
- To review the mortality patterns and predictors in patients with chronic obstructive pulmonary disease (COPD).
- To highlight the importance of accurate diagnosis and reporting for understanding COPD's true impact on mortality.
Main Methods:
- Review of data from large clinical trials (e.g., Lung Health Study, TORCH, UPLIFT, EUROSCOP, ISOLDE).
- Analysis of various mortality prediction measures including spirometry (FEV(1)), lung volumes, exercise capacity, dyspnea scores, and composite indices like the BODE index.
Main Results:
- Mortality causes in COPD vary with disease severity, transitioning from cancer/cardiovascular disease in mild cases to respiratory disease in severe cases.
- Key predictors of mortality include FEV(1), lung capacity ratios, exercise tolerance, dyspnea, and the BODE index.
Conclusions:
- Accurate assessment of COPD severity and appropriate risk stratification are crucial for patient management and survival.
- Interventions such as smoking cessation, oxygen therapy, lung volume reduction surgery, and lung transplantation can improve survival in select COPD patients.
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