부산대학교 도서관

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.rmed.2007.12.003 Byline: Karina Dela Coleta (a), Liciana V.A. Silveira (b), Daniela F. Lima (a), Eva A. Rampinelli (a), Ilda Godoy (c), Irma Godoy (a) Keywords: Pulmonary disease; Chronic obstructive/mortality; Dyspnea; Oxygen inhalation therapy/utilization Abstract: Little evidence-based guidance is available to aid clinicians in determining short-term prognoses in very severe COPD patients. Therefore, the present study was designed to provide a prospective assessment (1) of the mortality rates and (2) whether the baseline measurements may be determinants of 1-year mortality in hypoxemic COPD patients receiving long-term oxygen therapy (LTOT). Seventy-eight clinically stable patients with advanced COPD treated using LTOT were enrolled in a prospective cohort study. Outcome variable: first-year mortality. Baseline measurements: categorical variables: age (3); and corticosteroid use. Continuous variables: smoking history; lung function; FFM; fat mass; hemoglobin; hematocrit; arterial blood gases; forearm muscle strength; St. George's Respiratory Questionnaire (SGRQ); and comorbidity score. By the end of 1-year of follow-up, 12 patients (15.4%) had died. Kaplan-Meier curves showed that BDIa[c]1/23 was the only variable associated with higher mortality. Cox proportional hazards analysis revealed that lower PaO.sub.2 and SpO.sub.2, higher PaCO.sub.2 and SGRQ scores were associated with reduced survival. In the multivariate analysis, BDI remained predictive of mortality (hazard ratio [HR], 0.50; 95% confidence interval [CI], 0.31-0.81), as did PaO.sub.2 (HR, 0.49; 95% CI, 0.26-0.95). These data suggest that readily available parameters as dyspnea intensity and hypoxemia severity may be useful in predicting first-year survival rates in advanced COPD patients receiving LTOT. Author Affiliation: (a) Department of Internal Medicine, Pulmonology Division, Botucatu Medical School, UNESP -- Sao Paulo State University, Distrito de Rubiao Junior, s/n. Botucatu, SP, CEP 18618-000, Brazil (b) Department of Biostatistics, Biosciences Institute, UNESP -- Sao Paulo State University, Distrito de Rubiao Junior, s/n. Botucatu, SP, CEP 18618-000, Brazil (c) Department of Nursing, Botucatu Medical School, UNESP -- Sao Paulo State University, Distrito de Rubiao Junior, s/n. Botucatu, SP, CEP 18618-000, Brazil Article History: Received 1 July 2007; Accepted 3 December 2007