Chest
Clinical InvestigationsCopdDyspnea Is a Better Predictor of 5-Year Survival Than Airway Obstruction in Patients With COPD
Section snippets
COPD Case Registration
Case study meetings were held from October 1990 to February 1994 (eight meetings in all). We had asked participating physicians to mail the results of individual case examinations in advance and then distributed them to the participants at the meeting. Ten to 20 chest physicians from a total of 20 facilities participated in each meeting. Each facility presented its case with chest radiographs and CT scans of the patients. During the meeting, clinical, physiologic, and radiographic features were
Results
The characteristics of the 227 patients with COPD registered in the study are summarized in Table 1. The male to female ratio was approximately 9:1. Only two patients (0.8%) had never smoked. Symptoms of chronic bronchitis were considered to be present in 132 patients (58%). All patients had a wide range of airway obstruction.
Of the 227 patients enrolled, 183 patients were available for the follow-up examination (follow-up rate, 81%). Participating institutions declined to cooperate in 24
Discussion
This multicenter prospective study demonstrated that categorizing patients with COPD on the basis of the level of dyspnea was more closely correlated with survival than classification on the basis of disease severity as assessed by the percentage of predicted FEV1. Studies on the prognosis of patients with COPD have utilized various objective indexes as factors related to survival. The present study suggests that categorization by the level of dyspnea may be similarly useful in the prediction
ACKNOWLEDGMENT
This report represents a joint study involving longitudinal surveys conducted by the following medical institutions in Japan: Shizuoka City Hospital (Dr. T. Hirata), Third Department of Internal Medicine of Fukui Medical University (Dr. T. Ishizaki), Kyoto First Red Cross Hospital (Dr. M. Nakayama), Department of Respiratory Medicine of Graduate School of Medicine (formerly the Chest Disease Research Institute) of Kyoto University (Drs. A. Niimi and K. Nishimura), Tenri Hospital (Dr. K. Tomii),
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Financial support provided by Glaxo Wellcome K. K. in Japan.