Inspiratory capacity predicts mortality in patients with chronic obstructive pulmonary disease

Tantucci, Claudio; Donati, P.; Nicosia, Franco; Bertella, Enrica; Redolfi, Stefania; Vecchi, Massimiliano De; Corda, Luciano; Grassi, Vittorio; Zulli, Roberto

doi:10.1016/j.rmed.2007.11.004

Cited by 73 publications

(74 citation statements)

References 29 publications

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“…On day 1 the proportion of subjects with reduced inspiratory capacity (Ͻ 80% of predicted 25 ) was the same as the percentage with inspiratory muscle dysfunction (suggested by Vilaró et al 7 , as P Imax Ͻ 70% of predicted), which is 13 subjects (68%). Indeed, the inspiratory capacity of patients with inspiratory muscle dysfunction was lower than that of patients without inspiratory muscle dysfunction (62% of predicted [53-72% of predicted] vs 93% of predicted [71-139% of predicted], respectively, P ϭ .02), and the classifications of reduced inspiratory capacity and inspiratory muscle dysfunction were associated (phi coefficient 0.62, P ϭ .03).…”

Section: Respiratory Muscle Strength During and After Hospitalizationsupporting

confidence: 69%

Respiratory Muscle Strength During and After Hospitalization for COPD Exacerbation

et al. 2013

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BACKGROUND: A more profound investigation of respiratory muscle strength during COPD exacerbation was needed, so we investigated respiratory muscle strength and related factors in patients with COPD during and after hospitalization for COPD exacerbation. METHODS: In 19 subjects hospitalized for COPD exacerbation (12 males, mean age 67 ؎ 11 y, median percent-ofpredicted FEV 1 26% [IQR 19 -32%]) we measured lung function and respiratory and quadriceps muscle strength at admission (day 1), at discharge, and 1 month after discharge. RESULTS: At admission, 68% of the subjects had inspiratory muscle dysfunction (maximum inspiratory pressure < 70% of predicted O], P ‫؍‬ .001). Inspiratory capacity increased between discharge (1.59 ؎ 0.44 L) and 1 month after discharge (1.99 ؎ 0.54 L, P ‫؍‬ .02). There was no significant change in other lung function variables or quadriceps strength. At admission the inspiratory muscle dysfunction and reduction in inspiratory capacity (< 80% of predicted) correlated linearly (phi coefficient 0.62, P ‫؍‬ .03), whereas the expiratory muscle strength correlated inversely with FEV 1 (Spearman rho ؊0.61, P ‫؍‬ .005) and inspiratory capacity (Spearman rho ؊0.54, P ‫؍‬ .02). CONCLUSIONS: There was a high prevalence of inspiratory muscle dysfunction in patients hospitalized for COPD exacerbation. Inspiratory and expiratory muscle strength increased markedly during and after hospitalization. The degree of air-flow obstruction and hyperinflation were related to inspiratory and expiratory muscle strength.

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Section: Respiratory Muscle Strength During and After Hospitalizationsupporting

confidence: 69%

Respiratory Muscle Strength During and After Hospitalization for COPD Exacerbation

et al. 2013

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“…Dyspnea score and muscle strength were also significantly decreased for patients in the BODE index quartile groups 3-4. Thus, we consider the GOLD stage is an unclear criteria for physical ability, which is similar the reports above [3][4][5][6][7][8] . According to Fabbri et al 26) , 14% of patients who were clinically diagnosed with COPD were actually categorized in GOLD stage 0 in which FEV 1.0 / FVC is 70% or higher and more and %FEV 1.0 is 80% or higher.…”

Section: Discussionmentioning

confidence: 67%

“…While it is known that there is a correlation between FEV 1.0 and prognosis 2) , FEV 1.0 is simply one of many indices. It has also been reported that the inspiratory capacity (IC), exercise capacity, dyspnea score and body mass index (BMI) exhibit stronger correlations with prognosis [3][4][5][6][7][8] . Recently, the BMI, airway obstruction, dyspnea score, and exercise capacity (BODE) index, which is an evaluation method considering the multidimensional symptoms of COPD, have been used 9) .…”

Section: Introductionmentioning

confidence: 99%

A Comparison of the BODE Index and the GOLD Stage Classification of COPD Patients in the Evaluation of Physical Ability

et al. 2011

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Abstract.[Purpose] The aim of this cross-sectional study was to test whether the body mass index (BMI), airway obstruction, dyspnea, and exercise capacity (BODE) index is superior to the global initiative for chronic obstructive lung disease (GOLD) classification for physical ability, and to ascertain the usefulness of the BODE index in chronic obstructive pulmonary disease (COPD) patients. [Methods] We studied 48 patients with stable COPD (mean [±SD] age: 76.2±7.0 years). We measured BMI, modified medical research council (mMRC) dyspnea score, pulmonary function, muscle strength, timed up-and-go test (TUG), 6 minute walk distance (6MWD), and St. George's respiratory questionnaire (SGRQ). Comparisons of each measurement item in the BODE index quartile groups 1-2 and 3-4 were conducted for patients in GOLD Stages II and III.[Results] The mean total score for the BODE index was 3.9±2.9. The characteristics that showed a significant difference between the two groups were mMRC, %FVC, muscle strength, TUG and 6MWD. [Conclusions] This study showed that the GOLD classification assesses milder symptoms than the BODE index. The BODE index is as useful as the GOLD classification for physical ability, and also indicates comprehensive measures for COPD patients.

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“…8 Static hyperinflation can be determined by measuring IC and/or the ratio of IC to total lung capacity (IC/TLC). [8][9][10] Its increase during exercise is defined as dynamic hyperinflation (DH). During exercise, as ventilatory demand increases in flow-limited patients, progressive air trapping and further DH above the already increased resting value is inevitable.…”

Section: Introductionmentioning

confidence: 99%

“…11,14-16 A few longitudinal studies have assessed the impact of pulmonary hyperinflation on the prognosis of COPD. Recently, 2 studies assessed the impact of static hyperinflation on mortality in COPD patients and found that it was an independent predictor of mortality 8,10 ; however, the possible value of DH in predicting survival has not been adequately evaluated.…”

Section: Introductionmentioning

confidence: 99%

An Integrated Index Combined by Dynamic Hyperinflation and Exercise Capacity in the Prediction of Morbidity and Mortality in COPD

et al. 2012

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BACKGROUND: Dynamic hyperinflation (DH) and exercise limitation develop in patients with COPD; however, there is lack of knowledge about their long-term clinical consequences. We aimed to assess the impact of DH and exercise capacity in predicting mortality and also morbidity, as evaluated by emergency visits and hospital admissions in COPD patients during a 4-year period. METHODS: We recruited 73 stable COPD patients. The relationships of different respiratory parameters (FEV 1 %, body mass index, 6 min walk test distance [6MWD], static hyperinflation as measured by the ratio of inspiratory capacity to total lung capacity (IC/TLC) at rest, DH as measured by the change between the post-and pre-exercise values of IC/TLC [⌬IC/TLC], P aO 2 , and P aCO 2 ) with emergency visits and hospital admissions because of exacerbations and also with respiratory and all-cause mortality were assessed. RESULTS: The median follow-up period was 47 months (IQR 45-48 months, n ‫؍‬ 73). During the follow-up there were 8 (11%) deaths. The ⌬IC/TLC value was 3.9 ؎ 4.6%. The Kaplan-Meier survival curve showed that the cumulative survival rate was significantly lower in the patients with ⌬IC/TLC > 4 and with 6MWD < 439.56 m, using these values as thresholds. (The rates for sensitivity were 100% and 87.5%, and for specificity were 56.92% and 87.69%, respectively). The Cox proportional hazards model showed that DH (hazard ratio ‫؍‬ 1.4, 95% CI ‫؍‬ 1.09 -1.84, P ‫؍‬ .009) and 6MWD (hazard ratio ‫؍‬ 0.98, 95% CI ‫؍‬ 0.97-0.99, P ‫؍‬ .006) were independent predictors of all-cause and respiratory mortality. 6MWD, FEV 1 %, IC/TLC, and ⌬IC/TLC were found to be significantly related to emergency visits (r ‫؍‬ ؊0.28, r ‫؍‬ ؊0.41, r ‫؍‬ ؊0.24, and r ‫؍‬ 0.38, respectively) and hospital admissions (r ‫؍‬ ؊0.41, r ‫؍‬ ؊0.45, r ‫؍‬ ؊0.36, and r ‫؍‬ 0.28, respectively). CONCLUSIONS: DH and exercise capacity are reliable and independent predictors for mortality and morbidity in COPD patients. We propose that DH and exercise capacity be considered in the assessment of long-term clinical consequences of COPD patients.

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Inspiratory capacity predicts mortality in patients with chronic obstructive pulmonary disease

Abstract: IC (%pred.) is a powerful functional predictor of all-cause and respiratory mortality and of exacerbation-related hospital admissions in COPD patients.

Cited by 73 publications

References 29 publications

Respiratory Muscle Strength During and After Hospitalization for COPD Exacerbation

Respiratory Muscle Strength During and After Hospitalization for COPD Exacerbation

A Comparison of the BODE Index and the GOLD Stage Classification of COPD Patients in the Evaluation of Physical Ability

An Integrated Index Combined by Dynamic Hyperinflation and Exercise Capacity in the Prediction of Morbidity and Mortality in COPD

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