David Mannino, M.D., of the University of Kentucky Medical Center, and two associates found that patients with advanced COPD and rapid lung function decline are ten times more likely to die than individuals with normal lung function. Over the course of three years, the investigators analysed 13,756 middle-aged adults. The researchers tested the participants’ lung function twice - once at the start of the study and during a follow-up three years later.
The authors classified patients with the worst lung function as “rapid decliners.” Twenty-five percent of the entire study population (3,437 individuals) fell into this high-mortality category. Of the 720 subjects who died during the study, 273 (38 percent) were considered “rapid decliners.”
In addition, patients in advanced stages of COPD who were also “rapid decliners” were hospitalised at rate 40 times higher than those with normal lung function at baseline who had no rapid lung decline over the three-year period. “Mean annual loss of lung function in the overall cohort was 62 ml,” said Mannino. “The mean loss of lung function (FEV1) as a percentage of the baseline value was 1.5 percent annually. Participants in the most rapidly declining quartile of FEV1 had a mean annual loss of 171 ml, which was 4.7 percent of the baseline level per year.”
The authors noted that the average annual loss of 62 ml in lung function was higher than that shown in other similar studies, including the Honolulu Heart Cohort at 26 ml, the Busselton Health Study at 30 to 40 ml, the Nottingham Study at 38 ml, and the Copenhagen City Heart Study at 22 to 38 ml.
“The impact of rapid decline in FEV1 was stronger in adults with normal or near-normal lung function at baseline and suggests that this group of people may need more frequent screening and interventions beyond what is recommended,” said Mannino.
MEDICA.de; Source: American Thoracic Society (ATS)