Three-year follow-up study of respiratory and systemic manifestations of chronic obstructive pulmonary disease

• Published in: Brazilian journal of medical and biological research 2011-01, Vol.44 (1), p.46-52
• Main Authors: Ferrari, R, Tanni, S E, Faganello, M M, Caram, L M O, Lucheta, P A, Godoy, I
• Format: Article
• Language: English
• Subjects: Aged; BIOLOGY; BODE Index; Body Mass Index; Chronic obstructive pulmonary disease; Disease Progression; Exercise capacity; Exercise Tolerance - physiology; Female; Follow-Up Studies; Forced Expiratory Volume - physiology; Humans; Male; Markers of disease severity; MEDICINE, RESEARCH & EXPERIMENTAL; Middle Aged; Pulmonary Disease, Chronic Obstructive - physiopathology; Quality of life; Severity of Illness Index; Spirometry
• ISSN: 0100-879X; 1414-431X; 1414-431X; 0100-879X
• DOI: 10.1590/S0100-879X2010007500150

Few studies show patient outcomes over time in chronic obstructive pulmonary disease (COPD). In the present study, we monitored forced expiratory volume in the first second (FEV₁) and other manifestations of the disease over 3 years in 133 COPD patients (69% males, age = 65 ± 9 years, FEV₁ = 59 ± 25%) evaluated at baseline. During follow-up, 15 patients (11%) died and 23 (17%) dropped out. Measurements for 95 (72%) COPD patients alive after 3 years were analyzed. FEV₁, body mass index (BMI), 6-min walking distance (6MWD), Medical Research Council scale (MRC), Saint George's Respiratory Questionnaire (SGRQ), Charlson Comorbidity index, and BODE index were obtained at baseline and after 3 years. At baseline, 17 patients (18%) presented mild, 39% moderate, 19% severe, and 24% very severe COPD. Predicted FEV₁ % and BMI did not change over the period (P > 0.05). FEV₁ in liters [1.25 (0.96-1.72) vs 1.26 (0.88-1.60) L; P < 0.001], 6MWD (438 ± 86 vs 412 ± 100 m; P < 0.001), MRC [1 (1-2) vs 2 (1-3); P = 0.002], Charlson index [3 (3-4) vs 4 (3-5); P = 0.009], BODE index (2.2 ± 1.8 vs 2.6 ± 2.3; P = 0.008), and total SGRQ (42 ± 19 vs 44 ± 19%; P = 0.041) worsened after 3 years compared to baseline measurements. These data show that COPD patients deteriorated during the 3-year follow-up despite the fact that they had only minor modifications in airway obstruction and body composition. They support the need for comprehensive patient assessment to better identify disease progression.