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Body weight and comorbidity predict mortality in COPD patients treated with oxygen therapy

¹ Servei de Pneumologia, Hospital General Vall d'Hebron, and ² Laboratori de Bioestadística i Epidemiologia, Universtitat Autònoma de Barcelona, Barcelona, Spain.

CORRESPONDENCE: J. Ferrer, Servei de Pneumologia, Hospital General Vall d'Hebron, Passeig Vall d'Hebron, 119-129, 08035 Barcelona, Spain. Fax: 34 932746083. E-mail: jjferrer{at}vhebron.net

Keywords: Chronic obstructive pulmonary disease, comorbidity, mortality, oxygen inhalation therapy, weight loss

Received: June 30, 2005
Accepted December 12, 2005

The aim of this study was to investigate the association between clinical variables and all-cause and respiratory mortality in patients with chronic obstructive pulmonary disease (COPD) undergoing long-term oxygen therapy (LTOT).

The authors retrospectively studied a historic cohort of 128 patients with COPD (126 males, mean age±SD 68.9±9.7 yrs, body mass index (BMI) 25.1±4.5 kg·m^–2, and forced expiratory volume in one second 25.4±8.8% predicted), who were being treated with long-term oxygen therapy in a tertiary teaching hospital between 1992 and 1999. Comorbidity, assessed with the Charlson Index, was present in 38% of the patients. Vital status and cause of death were assessed through the population death registry.

A total of 78 patients (61%) had died by the end of follow-up. Three-year survival was 55%. Death was due to respiratory causes in 77% of cases. On Cox analysis, BMI <25 kg·m^–2, comorbid conditions, age 70 yrs and cor pulmonale were associated with all-cause mortality. The BMI and comorbidity were the only significant predictive factors when the analysis was restricted to respiratory mortality.

In conclusion, body mass index <25 kg·m^–2 and comorbidity were predictors of all-cause and respiratory mortality in a cohort of chronic obstructive pulmonary disease patients treated with long-term oxygen therapy. These factors should be taken into account when considering the management and prognosis of these patients.

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