Health Status and the Spiral of Decline

Figures & data

Figure 1 A model of COPD progression and consequences. The multiple consequences of COPD, including breathlessness, exercise limitation, muscle wasting, fatigue, and exacerbations.

Figure 2 Health status and FEV₁. In clinical trials of the effect of treatment in COPD, the correlation between changes in FEV₁ and SGRQ score is significant, but there is much scatter around the regression line. Source: ([8]).

Figure 3 SGRQ and FEV₁ Slopes in the Obstructive Lung Disease (ISOLDE) trial ([9]). Deterioration in SGRQ score was only weakly correlated with the decline in FEV₁. Source for figure data: Spencer S, Calverley PM, Burge PS, et al. Impact of preventing exacerbations on deterioration of health status in copd. Eur Respir J. 2004;23:698–702 ([9]).

Table 1 Stepwise multivariate cox proportional hazards analysis to investigate the most significant predictor of mortality in male patients with chronic obstructive pulmonary disease

	Relative Risk	95% Confidence Interval	p Value
Peak VO2, ml/mn	0.994	0.992–0.996	< 0.0001
Age, yr	1.077	1.010–1.149	0.024
Postbronchodilator FEV1, % predicted			0.056
DLO2/VA ml/min/L/mm Hg			0.089
Body Mass index, kg/m^2			0.21
Cumulative smoking, pack-years			0.32
SGRQ total			0.42

[Source: (16)].

Figure 4 Withdrawal from treatment as an outcome in the ISOLDE study of COPD. The estimated rate of deterioration in COPD may be skewed by early withdrawal of patients with worse health or faster decline ([19]).

Figure 5

Jones P W, Bosh T K. Quality of life changes in COPD patients treated with salmeterol. Am J Respir Crit Care Med 1997; 155(4)1283–1289

 PubMed Web of Science ®Google Scholar

Spencer S, Calverley P M, Burge P S, Jones P W. Impact of preventing exacerbations on deterioration of health status in COPD. Eur Respir J 2004; 23(5)698–702

 PubMed Web of Science ®Google Scholar

Calverley P M, Spencer S, Willits L, Burge P S, Jones P W. Withdrawal from treatment as an outcome in the ISOLDE study of COPD. Chest 2003; 124(4)1350–1356

 PubMed Web of Science ®Google Scholar