Elsevier

Respiratory Medicine

Volume 172, October 2020, 106132
Respiratory Medicine

Life expectancy (LE) and loss-of-LE for patients with chronic obstructive pulmonary disease

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Highlights

  • Few studies directly address the question of life expectancy (LE) and loss of LEfor severe stage COPD.

  • The loss-of-LE of severe stage COPD patients is almost the same as those with one or more severe AE history, or, 8-9 years.

  • 73.8% of COPD patients were under diagnosed.

  • Patients who were never made a diagnosis of COPD before their first time ofsevere AE had a loss-of-LE of 9.8 years.

Abstract

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.

Keywords

Life expectancy
Loss of life expectancy
Survival
COPD
Acute exacerbation

Abbreviations

chronic obstructive pulmonary disease
(COPD)
life expectancy
(LE)
acute exacerbation
(AE)
Global initiative of obstructive lung disease
(GOLD)
National Health Insurance
(NHI)
National Cheng Kung University
(NCKU)

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