Division of Pulmonary Medicine, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Respir Med. 2020 Oct;172:106132. doi: 10.1016/j.rmed.2020.106132. Epub 2020 Aug 29.
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.
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.
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).
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.
COPD 的预后通常以 3 年生存率表示，这可能不易被非专业人士理解。本研究旨在估计不同 GOLD 分期的 COPD 患者以及前一年因急性加重（AE）需要住院治疗（重度 AE）的患者的预期寿命（LE）和 LE 损失。
2006 年至 2016 年期间，在成大医院按照 GOLD 标准诊断为 COPD 的 532 例患者被纳入研究。通过 Kaplan-Meier 法估计生存率，并外推至终生以获得 LE。通过从国家生命表中减去 COPD 队列的 LE 来量化 LE 损失。通过国家健康保险数据集的全国性队列验证了有重度 AE 病史患者的生存率。
重度 COPD（GOLD 分级 3 和 4）患者的生存率几乎与有重度 AE 病史的患者相同，前者和后者的 LE 损失分别为 9.3（1.1）和 9.4（1.3）年。有重度 AE 病史的全国性队列（n=44764）显示 LE 损失为 8.3（0.1）年。中度 COPD（GOLD 分级 2）患者的 LE 损失为 6.2 年，但轻度 COPD（GOLD 分级 1）患者的 LE 没有减少。
我们成功地根据 GOLD 标准估计了 COPD 患者的 LE 和 LE 损失。重度 COPD 患者的生存率与有重度 AE 病史的患者几乎相同，或约有 8-9 年的生命损失。
