J 2018

Respiratory parameters predict poor outcome in COPD patients, category GOLD 2017 B

BRAT, Kristián, Marek PLUTINSKÝ, Karel HEJDUK, Michal SVOBODA, Patrice POPELKOVA et. al.

Basic information

Original name

Respiratory parameters predict poor outcome in COPD patients, category GOLD 2017 B

Authors

BRAT, Kristián (703 Slovakia, guarantor, belonging to the institution), Marek PLUTINSKÝ (703 Slovakia, belonging to the institution), Karel HEJDUK (203 Czech Republic, belonging to the institution), Michal SVOBODA (203 Czech Republic, belonging to the institution), Patrice POPELKOVA (203 Czech Republic), Jaromir ZATLOUKAL (203 Czech Republic), Eva VOLAKOVA (203 Czech Republic), Miroslava PECANINOVA (203 Czech Republic), Lucie HERIBANOVA (203 Czech Republic) and Vladimir KOBLIZEK (203 Czech Republic)

Edition

INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE, Auckland, Dove Medical Press Ltd. 2018, 1178-2005

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30203 Respiratory systems

Country of publisher

New Zealand

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 3.274

RIV identification code

RIV/00216224:14110/18:00103237

Organization unit

Faculty of Medicine

DOI

UT WoS

000428799800002

Keywords in English

COPD; GOLD 2017 update; Hypercapnia; Hypoxemia; Mortality

Tags

Tags

International impact, Reviewed
Změněno: 2/5/2019 13:31, Soňa Böhmová

Abstract

V originále

Background: Respiratory parameters are important predictors of prognosis in the COPD population. Global Initiative for Obstructive Lung Disease (GOLD) 2017 Update resulted in a vertical shift of patients across COPD categories, with category B being the most populous and clinically heterogeneous. The aim of our study was to investigate whether respiratory parameters might be associated with increased all-cause mortality within GOLD category B patients. Methods: The data were extracted from the Czech Multicentre Research Database, a prospective, noninterventional multicenter study of COPD patients. Kaplan–Meier survival analyses were performed at different levels of respiratory parameters (partial pressure of oxygen in arterial blood [PaO2], partial pressure of arterial carbon dioxide [PaCO2] and greatest decrease of basal peripheral capillary oxygen saturation during 6-minute walking test [6-MWT]). Univariate analyses using the Cox proportional hazard model and multivariate analyses were used to identify risk factors for mortality in hypoxemic and hypercapnic individuals with COPD. Results: All-cause mortality in the cohort at 3 years of prospective follow-up reached 18.4%. Chronic hypoxemia (PaO2<7.3 kPa), hypercapnia (PaCO2>7.0 kPa) and oxygen desaturation during the 6-MWT were predictors of long-term mortality in COPD patients with forced expiratory volume in 1 second #60% for the overall cohort and for GOLD B category patients. Univariate analyses confirmed the association among decreased oxemia (<7.3 kPa), increased capnemia (>7.0 kPa), oxygen desaturation during 6-MWT and mortality in the studied groups of COPD subjects. Multivariate analysis identified PaO2<7.3 kPa as a strong independent risk factor for mortality. Conclusion: Survival analyses showed significantly increased all-cause mortality in hypoxemic and hypercapnic GOLD B subjects. More important, PaO2<7.3 kPa was the strongest risk factor, especially in category B patients. In contrast, the majority of the tested respiratory parameters did not show a difference in mortality in the GOLD category D cohort.