End Stage Lung Disease Findings Indicating Survival of 6 Months or Less

Criteria – all of the following elements:

(1) severe lung disease (dyspnea at rest, unresponsive to bronchodilators; FEV1 post-bronchodilators < 30% of predicted)

(2) progressive disease (recent emergency room or hospital admission for respiratory failure; loss in FEV1 of >= 40 mL in past year)

(3) hypoxemia at rest (oxygen saturation < 88% on room air; PaO2 < 55 mm Hg on room air)

(4) carbon dioxide retention (PaCO2 > 50 mm Hg)

where:

• A loss of 40 mL in FEV1 seems relatively small to me.

Additional poor prognostic factors:

(1) evidence of cor pulmonale

(2) unintentional weight loss of > 10% body weight in 6 months

(3) resting tachycardia (> 100 beats per minute)