Predictors of Survival in a Group of Patients with Chronic Airflow Obstruction

• Published in: Journal of clinical epidemiology Vol. 51; no. 7; pp. 547 - 555
• Main Authors: Piccioni, P., Caria, E., Bignamini, E., Forconi, G., Nebiolo, F., Arossa, W., Bugiani, M.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.07.1998; Elsevier
• Subjects: adherence; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Blood Gas Analysis; care program; Cause of Death; Chronic airflow obstruction (CAO); Chronic obstructive pulmonary disease, asthma; Female; Follow-Up Studies; Forced Expiratory Volume; Humans; Linear Models; Lung Diseases, Obstructive - diagnosis; Lung Diseases, Obstructive - mortality; Lung Diseases, Obstructive - therapy; Male; Medical sciences; Middle Aged; Oxygen Inhalation Therapy; Patient Compliance; Pneumology; Predictive Value of Tests; Proportional Hazards Models; survival; Survival Analysis; Vital Capacity; Italy; Europe; Chronic airflow obstruction (CAO); adherence; care program; survival; Human; Lung disease; Evaluation; Sanitary program; Prognosis; Respiratory disease; Predictor; Epidemiology; Survival; Indicator; Care; Asthma; Chronic; Cohort study; Bronchus disease; Obstructive pulmonary disease; Public health
• ISSN: 0895-4356; 1878-5921
• DOI: 10.1016/S0895-4356(98)00022-5

This article shows the results of a 10-year follow-up study conducted on a cohort of 870 patients affected by severe chronic airflow obstruction (CAO) on spirometric tests. The main aims of the study were to identify those factors associated with reduced survival in CAO patients and to evaluate the effectiveness of a care program on patients’ survival. The analysis compared the survival time and causes of death between patients who showed adherence and patients who did not show adherence to the care program. The most important results can be summarized as follows: (1) CAO patients have a high mortality rate for acute respiratory failure, cor-pulmonale, and lung cancer; (2) patient’s age at the time of selection to enter follow-up influences the death hazard; (3) patients who need long-term oxygen treatment (LTOT) have a higher death hazard than those who don’t need it; (4) the higher is FEV1 or PaO2 value at the time of selection, the lower the death hazard; (5) patients who need, and regularly take, long-term oxygen treatment have a lower death hazard compared to those who need it, but do not take it properly; and (6) patients with a partial reversible airway obstruction (pRAO) who regularly attend the clinic for planned check-ups, have a lower death hazard compared to those who have the same characteristics, but do not show adherence to the care program. These results indicate that an organized program to treat severe CAO patients may improve their survival.