@article {MakitaP4721, author = {Hironi Makita and Masaru Suzuki and Katsura Nagai and Masaharu Nishimura and Hokkaido COPD Cohort Study Group}, title = {Relationship of baseline or annual change of clinical parameters on mortality in patients with COPD}, volume = {42}, number = {Suppl 57}, elocation-id = {P4721}, year = {2013}, publisher = {European Respiratory Society}, abstract = {Background: We have shown that the rate of annual change in FEV1 was varied widely among patients with COPD over 5 years (Nishimura, AJRCCM 2012). Aim: To examine how baseline or annual changes of clinical parameters are related to mortality. Methods: A total of 279 of clinically stable patients with COPD (GOLD 1, 26\%; GOLD 2, 45\%; GOLD 3/4, 29\%) served as subjects. We collected BMI and spirometric data every 6 months, diffusing capacity (Kco), emphysema severity assessed by CT, and health-related QOL (SGRQ) every year, and monitored exacerbation frequency, smoking behavior, and any medications. Mortality of the subjects was continuously recorded by physicians, telephone interviews, and letters to their families. Annual changes in post-bronchodilator FEV1, BMI, Kco, and SGRQ until the 3rd year were determined by linear regression. Results: The median follow-up time was 8.2 years. Of the 265 patients, 98 died, with 38 classified as respiratory deaths. Age, emphysema score, BMI, FEV1 (\%), Kco, SGRQ, exacerbations, and usage of respiratory medications were significantly related to mortality of all causes of death. By a multivariate logistic regression analysis, age (odds ratio [OR] 1.16; 95\%CI 1.11-1.22; p\<0.001), Kco (OR 0.99; 95\%CI, 0.97-0.998; p=0.03), and BMI (OR 0.88; 95\%CI, 0.79-0.97; p=0.01) emerged as independent risk factors for mortality of all causes. Interestingly, when looking at indices of annual changes, an annual decline in Kco was significantly linked with mortality of any respiratory diseases. Conclusion: An annual decline in Kco, besides age, BMI, Kco at baseline, is an independent risk factor of mortality of any respiratory diseases in patients with COPD.}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/42/Suppl_57/P4721}, eprint = {https://erj.ersjournals.com/content/42/Suppl_57/P4721.full.pdf}, journal = {European Respiratory Journal} }