Chest
Clinical InvestigationsSurvival of Chronic Hypercapnic COPD Patients Is Predicted by Smoking Habits, Comorbidity, and Hypoxemia
Section snippets
Study Population
A cohort of 47 chronic hypercapnic COPD patients (28 male; mean age, 66.3 ± 6.7 years [± SD]) recruited for other trials, of 1 to 3 weeks in duration, in our institute between January 1996 and February 2000 was prospectively followed up, yielding 178.8 person-years in total.293031 Follow-up time ranged from 3.1 to 7.1 years among survivors.
COPD was defined according to the standards of the American Thoracic Society.17 Chronic hypercapnia was defined as Paco2 > 45.0 mm Hg recorded twice with an
Results
At the time of analysis, 18 deaths had occurred (10 male patients) in 47 chronic hypercapnic subjects, contributing in total 178.8 person-years of follow-up. Thus, the overall survival rate after 3.8 years was 61.7%. Ten subjects (55.6%) died of acute-on-chronic respiratory failure triggered by an acute exacerbation of COPD (n = 9) or pneumonia (n = 1). Two subjects (11.1%) died of the consequences of late-stage lung cancer. The others died of unknown causes.
Our group of subjects consisted of
Discussion
Respiratory muscle strength and HCVR were not related to the prognosis of chronic hypercapnic COPD patients. Current smoking, the presence of comorbidity, and the level of hypoxemia, however, did predict survival in these patients.
Respiratory muscle weakness in COPD patients causes hypoventilation with subsequent hypercapnia and hypoxemia. Hypercapnia is regarded a poor prognostic indicator in COPD patients in general.1926 We hypothesized that within the subgroup of hypercapnic COPD patients,
Acknowledgment
The authors thank Drs. F. Brijker and M. Wagenaar for assistance in conducting this study.
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