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Braz. J. Med. Biol. Res. · Jan 2011
Three-year follow-up study of respiratory and systemic manifestations of chronic obstructive pulmonary disease.
- R Ferrari, S E Tanni, M M Faganello, L M O Caram, P A Lucheta, and I Godoy.
- Departamento de Clínica Médica, Universidade Estadual Paulista, Botucatu, SP, Brasil. renataferrarifisio@gmail.com
- Braz. J. Med. Biol. Res. 2011 Jan 1;44(1):46-52.
AbstractFew 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.
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