Document Detail

The Progression of Chronic Obstructive Pulmonary Disease is Heterogeneous: The Experience of the BODE Cohort.
MedLine Citation:
PMID:  21836135     Owner:  NLM     Status:  Publisher    
RATIONALE: COPD is thought to result in rapid and progressive loss of lung function usually expressed as mean values for whole cohorts. Longitudinal studies evaluating individual lung function loss and other domains of COPD progression are needed. METHODS: We evaluated 1198 stable, well-characterized COPD patients (1100 males) recruited in 2 centers (Florida; Tenerife) and annually monitored their multi-domain progression from 1997 to 2009. Patients were followed for a median of 64 months and up to ten years. Their individual FEV1 (L) and BODE index slopes, expressed as annual change, were evaluated using regression models for repeated measures. 751 patients with at least three measurements were used for the analyses. RESULTS: Eighteen percent of patients had a statistically significant FEV1 slope decline [-86 ml/yr (CI 95%: -32; -278 ml/yr)]. Higher baseline FEV1 (RR 1.857; 95%CI: 1.322-2.610, p <0.001) and low BMI (RR 1.071; 95%CI: 1.035-1.106, p <0.001) were independently associated with FEV1 decline. The BODE index had a statistically significant increase (0.55, 0.20-1.37 point/yr) in only 14% of patients and these had more severe baseline obstruction. Concordances between FEV1 and BODE change was low (κ Cohen: 16%). Interestingly, 73% of patients had no significant slope change in FEV1 or BODE. Only the BODE change was associated with mortality in patients without FEV1 progression. CONCLUSIONS: The progression of COPD is very heterogeneous. A majority of patients show no statistical significant decline of FEV1 or increase in BODE. The multidimensional evaluation of COPD should offer insight into response to COPD management.
Ciro Casanova; Juan P de Torres; Armando Aguirre-Jaíme; Victor Pinto-Plata; Jose M Marin; Elizabeth Cordoba; Rebeca Baz; Claudia Cote; Bartolome R Celli
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-8-11
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  -     ISSN:  1535-4970     ISO Abbreviation:  -     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-8-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Pulmonary Department and Research Unit, Hospital Universitario La Candelaria, Tenerife, Spain.
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