[Course and prognosis of chronic obstructive lung disease over 5 and 10 years]

453 patients aged over 40 hospitalized with severe COPD, a mean age of 66 years and mean FEV1 of 1.24 litres (49% predicted) were prospectively followed up for 5 years (341) and 10 years (195) respectively. 5-year survival was 47%, while 10-year survival was severely limited despite uniform therapy (23%). Average survival was only 4.4 years. Of the 15 prognostic factors considered, initial FEV1, body-weight, smoking behavior, diagnosis of bronchial asthma or emphysema, finding of p pulmonale and reversibility of bronchodilation had a significant influence on survival. The average decrease in FEV1 per year was only 28 ml in the surviving patients. It was lowest in those with FEV1 reversibility of more than 105 ml after bronchodilation. A maximum increase of FEV1 of more than 485 ml during the initial hospitalization, together with stopping smoking, were the next two important factors in FEV1 decrease. Mean annual NO2 concentration at home did not correlate significantly with survival and FEV1 decrease.