Yohannes et al evaluated older adults with chronic obstructive pulmonary disease. These can help identify patients who may benefit from more aggressive management. The authors are from Manchester Royal Infirmary in England.


Patient selection:

(1) age >= 60 years

(2) clinically stable

(3) no change in medications for 4 weeks

(4) no hospital admission in past 6 weeks


Risk factors associated with mortality:

(1) impairment (as measured by the Manchester Respiratory Activities of Daily Living, MRADL)

(2) FEV1 prior to bronchodilator therapy

(3) body mass index (BMI)

(4) duration of home oxygen therapy


The betas for the factors are given in Table I, page 138, but the constant is not given.


Risk factors associated with mortality:

(1) severe impairment

(2) FEV1 < 30% of predicted prior to bronchodilator therapy (using the severe category from the GOLD criteria)

(3) moderate to marked thinness

(4) long term home oxygen therapy


Risk factors associated with impending risk:

(1) moderate impairment

(2) FEV1 30-49% of predicted prior to bronchodilator therapy

(3) mild thinness

(5) short term home oxygen therapy


Factors found NOT to be predictors:

(1) current smoking

(2) number of pack years smoked (does determine risk of cancer)

(3) severity of depression

(4) quality of life score

(5) comorbid disease (covered by degree of impairment)

(6) social class


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