[Probability of survival and prognostic factors in chronic obstructive lung disease]

The course of chronic obstructive pulmonary disease (COPD) is described over a 3-7 year period in 201 patients treated by family physicians and in the same hospital. The probability of survival after 3 years is 63% (normal population of same age 85%) and after 5 years 48% (normal 75%) for all patients. These figures are comparable with data in the literature of the last 12 years (42-69% 5-year survival). The patients in our study are 68 years old on average and have an FEV1 of 1.3 liters. The prognosis of COPD is significantly influenced by the following factors: ECG signs of cor pulmonale, clinical signs of heart failure, vital capacity, FEV1 and paCO2. For example, within a 3 year period 63 of 124 patients with heart failure died as compared to only 3 of 57 without. Retrospective analysis shows inhalation therapy by motor-driven nebulizers to have a favourable effect on survival. For IPPB home therapy a favourable effect can only be shown after stratification for the two most significant prognostic factors to exclude therapeutic bias. No effect on survival was noted with long-term steroid therapy. 11% of patients who have never smoked, and those who have stopped smoking, live significantly (p less than 0.002) longer than those who continued to smoke more than 3 cigarettes per day during the observation period.