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COPD (Chronic Obstructive Pulmonary Disease)

Lungs

03/16/2010

Question:

ive just been diagnosed with emphysema and im only 44years old. im not sure at what stage im at ive been for a full lung function test today but am not due to see my consultant until june. please could you let me know how long ive got left.

Answer:

Thank you for visiting NetWellness and for your question. NetWellness receives many questions about life expectancy in people with COPD. Only a health professional completely familiar with your case can answer specific questions about prognosis. However, here are some guidelines to discuss with your physician. Keep in mind, these are only statistics and we cannot predict life expectancy well for any disease.

Life Expectancy - Some information is available on prognosis in COPD patients, but it is limited. Traditionally, prognosis has been reported based on the FEV1, which is a part of PFT. An FEV1 of less than 35% of predicted means very severe disease and some studies estimate that more than half of patients with very severe disease may not be expected to survive for four years.

In addition to the FEV1, other factors that predict prognosis are
* the person's weight (very low weight is bad in this case),
* the distance walked in six minutes, and
* the degree of shortness of breath with activities.

These factors are called the BODE index and can be used to provide information on prognosis for one-year, two-year, and four-year survival. For example, a person who has lung impairment with an FEV1 of 20%, shortness of breath when getting dressed, and the ability to walk only 500 feet in six minutes has a two year survival rate of 69%. Based on studies, 31 out of 100 similar people will not survive two years.

Expected survival for individuals cannot be determined in this forum, but important questions to ask your physician or health care provider might include the following:
* How severe is your COPD based on pulmonary function tests (what is your forced expiratory volume in 1 second [FEV1])?
* Do you have higher than normal carbon dioxide levels?
* Are you using oxygen?
* How short of breath are you--at rest? --with mild activity? --with higher levels of activity?
* Can you walk very far or are you limited to a chair or bed?
* Have you ever participated in pulmonary rehabilitation?
* How is your weight? Are you very thin?

Improving Survival - Smoking cessation is the most important treatment in COPD and improves survival. Oxygen therapy has been shown to improve survival if a patient has low oxygen levels. Pulmonary rehabilitation, while not shown to improve survival overall, does dramatically improve activity tolerance and, therefore, quality of life.

For more information:

Go to the COPD (Chronic Obstructive Pulmonary Disease) health topic, where you can:

Response by:

Michael E Ezzie, MD Michael E Ezzie, MD
Clinical Assistant Professor of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University