Background and objectives

Prognosis of COPD is usually expressed as a 3-year survival rate, which might not be easily understood by lay people. This study estimates the life expectancy (LE) and loss-of-LE for COPD patients with different GOLD stages and patients with a history of acute exacerbation (AE) requiring hospitalization (severe AE) in the preceding year.

Methods

532 patients who were diagnosed with COPD according to the GOLD criteria at NCKU hospital between 2006 and 2016 were recruited. Survival was estimated by Kaplan-Meier method, and extrapolated to lifetime to obtain the LE. The loss-of-LE was quantified by subtracting the LE of the COPD cohort from national life tables. The survival of patients with severe AE history was validated by a nation-wide cohort from the National Health Insurance dataset.

Results

The survival of patients with severe stage COPD (GOLD grades 3 and 4) was almost the same as those patients with a history of severe AE and the loss-of-LE for the former and the latter were 9.3 (1.1) and 9.4 (1.3) years, respectively. The nation-wide cohort with severe AE history (n = 44,764) showed a loss-of-LE of 8.3 (0.1) years. The loss-of-LE of patients with moderate stage COPD (GOLD grade 2) was 6.2 years, but no reduction in LE was noted for mild stage COPD (GOLD grade 1).

Conclusions

We successfully estimated LE and loss of LE in COPD patients under the GOLD criteria. The survival of severe stage COPD patients is almost the same as those with severe AE history, or about 8–9 years of life lost.

中文翻译：

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慢性阻塞性肺疾病患者的预期寿命（LE）和LE损失。

背景和目标

COPD的预后通常表示为3年生存率，这对于外行人可能不容易理解。这项研究估计了不同GOLD分期的COPD患者和前一年有急性加重病史（AE）需要住院治疗（严重AE）的患者的预期寿命（LE）和LE损失。

方法

招募了532名在2006年至2016年期间根据NCKU医院的GOLD标准诊断为COPD的患者。通过Kaplan-Meier方法估计存活率，并将其外推至寿命以获得LE。通过从国民生活表中减去COPD队列的LE来量化LE的损失。具有严重AE史的患者的生存率已通过国家健康保险数据集中的全国性队列进行了验证。

结果

重度COPD患者（GOLD 3和4级）的生存率与有严重AE史的患者几乎相同，前者和后者的LE损失分别为9.3（1.1）和9.4（1.3） ）年。具有严重AE历史（n = 44,764）的全国性队列显示LE丧失8.3（0.1）年。中度COPD（GOLD 2级）患者的LE丢失为6.2年，但轻度COPD（GOLD 1级）的LE并未减少。

结论

我们根据GOLD标准成功地估计了COPD患者的LE和LE丢失。重度COPD患者的存活率与严重AE史或大约8-9年生命丧失者相同。