Tidal volume expandability and ventilatory efficiency as predictors of mortality in Taiwanese male patients with chronic obstructive pulmonary disease: A 10-year follow-up study - Is V ̇O < sub > 2peak < /sub > or FEV < sub > 1 < /sub > % the gold standard?

This study aimed to investigate the predictive power of physiological variables on all-cause mortality in COPD patients compared to peak oxygen uptake (V˙O2peak) and forced expired volume in one second (FEV1). We conducted a retrospective study of 182 COPD patients with complete lung function tests, cardiopulmonary exercise testing (CPET), and survival data. Cox regression analysis was used to estimate the hazard ratios for all-cause mortality. The median follow-up period was 6.8 (IQR 3.9-9.2) years. Out of the 182 patients in our study, sixty-two (34.1%) succumbed to various causes. Of these, 27.4% (n = 17) experienced acute exacerbations, 24.2% (n = 15) had advanced cancer, and 12.9% (n = 8) had cardiovascular disease as the primary cause of death. Another 25.8% (n = 16) passed away due to other underlying conditions, while 6.5% (n = 4) had an unknown cause of death. One patient's demise was attributed to a benign tumor, and another's to a connective tissue disease. The ratio of tidal volume to total lung capacity (VTpeak/TLC) and the ratio of minute ventilation and V˙O2 at nadir (V˙E/V˙O2nadir) (AUR 0.83, 95% CI 0.76-0.91) were superior predictors of all-cause mortality compared to V˙O2peak and FEV1%. A mortality prediction formula was derived using these variables. This study highlights the potential of VTpeak/TLC and V˙E/V˙O2nadir as predictive markers for COPD all-cause mortality in COPD. CPET is an effective tool for evaluating COPD mortality; however, the predi...
Source: Chronic Respiratory Disease - Category: Respiratory Medicine Authors: Source Type: research