Emphysema-Predominant COPD Had a Greater 5-Year Mortality and a Worse Annual Decline in Lung Function Than Airway Obstruction-Predominant COPD or Asthma at Initial Same Degree of Airflow Obstruction
<i>Background and Objectives:</i> We studied whether the extent of exertional oxygen desaturation and emphysema could cause greater mortality in COPD and asthma independent of airflow obstruction. <i>Materials and Methods:</i> We performed a 5-year longitudinal observational...
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| Autores principales: | , , , , , , , , , |
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| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
MDPI AG
2021
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| Materias: | |
| Acceso en línea: | https://doaj.org/article/bdb206d500cd4eb09cfe0e25ae87af32 |
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| Sumario: | <i>Background and Objectives:</i> We studied whether the extent of exertional oxygen desaturation and emphysema could cause greater mortality in COPD and asthma independent of airflow obstruction. <i>Materials and Methods:</i> We performed a 5-year longitudinal observational study in COPD and asthma patients who matched for airflow obstruction severity. All subjects performed a 6-min walk test (6MWT) and high-resolution computed tomography (HRCT) and followed spirometry and oxygen saturation (SpO<sub>2</sub>) during the 6MWT every 3–6 months. Overall survival was recorded. Cumulative survival curves were performed according to the Kaplan–Meier method and compared with the log-rank test. <i>Results:</i> The COPD group had higher emphysema scores, higher Δinspiratory capacities (ICs) and lower SpO<sub>2</sub> during the 6MWT, which showed a greater yearly decline in FEV<sub>1</sub> (40.6 mL) and forced vital capacity (FVC) (28 mL) than the asthma group (FEV<sub>1</sub>, 9.6 mL; FVC, 1.2 mL; <i>p</i> < 0.05). The emphysema-predominant COPD group had an accelerated annual decline in lung function and worse survival. The nadir SpO<sub>2</sub> ≤ 80% and a higher emphysema score were the strong risk factors for mortality in COPD patients. <i>Conclusions:</i> The greater structural changes with a higher emphysema score and greater desaturation during the 6MWT in COPD may contribute to worse yearly decline in FEV<sub>1</sub> and higher five-year mortality than in asthma patients with a similar airflow obstruction. The lowest SpO<sub>2</sub> ≤ 80% during the 6MWT and emphysema-predominant COPD were the strong independent factors for mortality in chronic obstructive airway disease patients. |
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