Introduction: There is considerable controversy on the possible predictors of lung function decline in COPD. Aims: To evaluate wheter clinical and anthropometric characteristics and white blood cell count may be associated with the decline in FEV1 in COPD. Methods: We retrospectively selected 240 subjects referring to our outpatient clinic between 2010 and 2013 with a minimum follow-up of 34 months. We included in the study patients with baseline and follow-up information about: spirometric data, white blood cell count, anthropometric characteristics, smoking status, dyspnea (mMRC scale), chronic bronchits (cough and pleghm), history of AECOPD, treatment. Statistical analysis were performed by multivariate linear regression model, using FEV1% annual change as outcome, and age, sex, BMI, smoking status, eosinophils and neutrophils count, symptoms, AECOPDs and treatment as possible determinants. Results: A total of 70 patients were included (age 70,7±6,8yrs, 18 women, FEV1 1,56±0,68L/min, GOLD stage I, II, III+IV, 21, 32 and 17 pts respectively). Five subjects were active smokers. The BMI was 27,0±3,22 and the white blood cell count resulted normal in all subjects. The mean annual FEV1 decline was 0,014 L. In our model, eosinophil count (B 16.9; CI 0.94,32.8; p=0.039) and age were positively associated to FEV1 decline, i.e. the higher the eosinophil count and the age, the greater the functional decline. On the contrary, there was a negative association with BMI (B -0.34; CI -0.66,-0.022). p=0.037). Conclusions: Blood eosinophils, although in the normal range, are related to a faster decline in lung function. Moreover, a higher BMI may protect against FEV1 decline over the time.
Predictors of lung function decline: a retrospective study in COPD patients
Spelta, F;PIZZINI, MICHELA;Cazzoletti, L;Ferrari, P;Zambon, G;Ferrari, M
2018-01-01
Abstract
Introduction: There is considerable controversy on the possible predictors of lung function decline in COPD. Aims: To evaluate wheter clinical and anthropometric characteristics and white blood cell count may be associated with the decline in FEV1 in COPD. Methods: We retrospectively selected 240 subjects referring to our outpatient clinic between 2010 and 2013 with a minimum follow-up of 34 months. We included in the study patients with baseline and follow-up information about: spirometric data, white blood cell count, anthropometric characteristics, smoking status, dyspnea (mMRC scale), chronic bronchits (cough and pleghm), history of AECOPD, treatment. Statistical analysis were performed by multivariate linear regression model, using FEV1% annual change as outcome, and age, sex, BMI, smoking status, eosinophils and neutrophils count, symptoms, AECOPDs and treatment as possible determinants. Results: A total of 70 patients were included (age 70,7±6,8yrs, 18 women, FEV1 1,56±0,68L/min, GOLD stage I, II, III+IV, 21, 32 and 17 pts respectively). Five subjects were active smokers. The BMI was 27,0±3,22 and the white blood cell count resulted normal in all subjects. The mean annual FEV1 decline was 0,014 L. In our model, eosinophil count (B 16.9; CI 0.94,32.8; p=0.039) and age were positively associated to FEV1 decline, i.e. the higher the eosinophil count and the age, the greater the functional decline. On the contrary, there was a negative association with BMI (B -0.34; CI -0.66,-0.022). p=0.037). Conclusions: Blood eosinophils, although in the normal range, are related to a faster decline in lung function. Moreover, a higher BMI may protect against FEV1 decline over the time.
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