Body weight and comorbidity predict mortality in COPD patients treated with oxygen therapy

Abstract

The aim of this study was to investigate the association between clinical variables and all-cause and respiratory mortality in patients with chronic obstructive pulmonary disease (COPD) undergoing long-term oxygen therapy (LTOT).The authors retrospectively studied a historic cohort of 128 patients with COPD (126 males, mean age¡SD 68.9¡9.7 yrs, body mass index (BMI) 25.1¡4.5 kg?m -2, and forced expiratory volume in one second 25.4¡8.8% predicted), who were being treated with long-term oxygen therapy in a tertiary teaching hospital between 1992 and 1999. Comorbidity, assessed with the Charlson Index, was present in 38% of the patients. Vital status and cause of death were assessed through the population death registry.A total of 78 patients (61%) had died by the end of follow-up. Three-year survival was 55%. Death was due to respiratory causes in 77% of cases. On Cox analysis, BMI ,25 kg?m -2 , comorbid conditions, age o70 yrs and cor pulmonale were associated with all-cause mortality. The BMI and comorbidity were the only significant predictive factors when the analysis was restricted to respiratory mortality.In conclusion, body mass index ,25 kg?m -2 and comorbidity were predictors of all-cause and respiratory mortality in a cohort of chronic obstructive pulmonary disease patients treated with long-term oxygen therapy. These factors should be taken into account when considering the management and prognosis of these patients.

Perfil nutricional de pacientes candidatos ao transplante de pulmão

“…Nevertheless, based on MAMC, 55% of the patients with PE presented some degree of depletion, either moderate or severe, and this can indicate a deficit in lean body mass. According to other studies, (17)(18)(19) critical patients with COPD at the highest risk of death presented a BMI < 25 kg/m 2 . According to two authors, (14) determining body fat reserves in patients with COPD is extremely important, since, without these reserves, the organism begins to mobilize its own protein reserves as an energy source.…”

Accuracy and reliability of pulse oximetry at different arterial carbon dioxide pressure levels

“…Many patients with end-stage lung disease have chronic respiratory failure and present elevated arterial carbon dioxide pressure (Pa,CO 2 ) [15]. Currently, there are no studies that determine [16], a frequent situation in this population [11][12][13].…”

Réhabilitation respiratoire dans la broncho-pneumopathie chronique obstructive (BPCO) : l’androgénothérapie, pourquoi ? Pour qui ? Comment ?

“…Comme la perte musculaire touche l'ensemble des muscles squelettiques y compris respiratoires, la dénutrition chronique et la perte musculaire du patient BPCO conduisent à l'inactivité physique [4,12], au déconditionnement à l'exercice [13], et à la dégradation de la fonction respiratoire [14]. Cela aboutit à une altération de la qualité de vie [4,12], une augmentation des infections bronchiques, du recours au médecin généraliste [15], et de la mortalité [4,12,[16][17][18][19][20][21][22][23][24][25][26]. Le corollaire est une augmentation des coûts de santé de la BPCO même si les études médico-économiques sont largement manquantes.…”

“…Ces coûts vont certainement s'accroître dans le futur du fait du vieillissement de la population, de l'augmentation de prévalence de la BPCO [27], et des progrès de la médecine. Il est établi que l'impact de la dénutrition et de la perte de masse non grasse sur la morbi-mortalité est indépendant des paramètres respiratoires [16][17][18][19]. Plusieurs études ont démontré que la perte de masse non grasse, mesurée par bioimpédancemétrie corporelle bioélec-trique (BIA) ou scanner centré sur le milieu de la cuisse, étaient de meilleurs prédicteurs de mortalité que l'indice de masse corporelle (IMC) [16,20,21,24].…”