Title: Analysis of the course of chronic obstructive pulmonary disease in a fifteen- year follow-up.

Abstract:

Chronic obstructive pulmonary disease (COPD) is an important medical and social problem due to its growing prevalence and negative impact on the quality of life and prognosis. A growing body of evidence strengthens the understanding of the significance of various factors in the clinically heterogeneous course of COPD.
Methods: COPD progression was monitored over 15 years at three-time points (at study inclusion, after 3 years, and after 15 years). A total of 170 men with COPD were included in the study. Smoking history, the severity of respiratory symptoms, body mass index (BMI), and spirometry data were taken into account. To assess the significance of the factors, we performed a Kaplan-Meier analysis of long-term survival. Multivariate Cox regression model analysis was used to assess the influence of various factors and their combinations on long-term survival.
Results: Of the 170 patients included in the study, 119 died by the third time point, which was 70%. The mean life expectancy of those who died was 70.48 ± 0.63 years. The results of the study showed that comorbid atherosclerotic cardiovascular disease was a major cause of death in patients with COPD. Survival analysis using Kaplan-Meier curves showed that BMI;21 was associated with a poor prognosis. The analysis also showed that the frequency of exacerbations correlated with the severity of the course and prognosis. An increase in the frequency of exacerbations by more than 3 per year was an independent predictor of a negative prognosis. Another factor was physical frailty. Individuals who move only within the confines of the home have been found to have a worse prognosis. A high Charlson comorbidity index was a factor of adverse prognosis. Cox regression model results showed that atherosclerotic cardiovascular disease, high frequency of COPD exacerbations, and high FEV1 decline rate were significant predictors of poor prognosis in patients with COPD at 15-year follow-up.
Conclusion: Thus, comorbid atherosclerotic cardiovascular disease, low BMI, high exacerbation rate, rapid FEV1 decline, physical frailty, and high Charlson index are significant factors of poor prognosis of COPD and should be considered in patient follow-up.

Biography:

Stanislav Kotlyarov was educated as a medical doctor in 2007 and received his Ph.D. in 2011. His thesis was on "Structure of respiratory symptoms and spirometry screening in the assessment of chronic obstructive pulmonary disease at the primary treatment level". He works at Ryazan State Medical University as head of the department. He is board-certified as a general practitioner and family medicine physician. Was involved in clinical trials of medicines and medical devices. He has over 50 publications, including several articles in leading international peer-reviewed journals. Areas of research interests: molecular immunology, and molecular pharmacology of respiratory and cardiac diseases.