Risk factors for accelerated decline among patients with chronic obstructive pulmonary disease

American Journal of Respiratory and Critical Care Medicine
H A KerstjensD S Postma

Abstract

The interpretation of studies of decline of FEV1 in patients with established COPD is complicated by many methodologic problems, such as retrospective analyses, small patient groups, different patient selection, and differences in the mathematical models used. Nevertheless, it is clear that the rate of loss of lung function is above all determined by the smoking status and history. A more abnormal bronchoconstrictor response is predictive of a steeper decline of lung function. Other prognostic factors have not been consistently found in patients with established disease. The decline can be influenced favorably by smoking cessation, and probably by oxygen administration in hypoxemic patients. Long-term oral steroid use seems to be associated with a more favorable course of FEV1, but the value of inhaled corticosteroids has not yet been established. Maintenance therapy with bronchodilators only does not appear to improve the decline of FEV1.

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Citations

Jan 19, 2005·Der Internist·H R Wirtz
Jan 3, 2001·The New England Journal of Medicine·UNKNOWN Lung Health Study Research GroupMelissa Skeans
Sep 2, 1998·Proceedings of the National Academy of Sciences of the United States of America·S J GangeJ B Margolick
Apr 2, 2011·High Altitude Medicine & Biology·Denis VinnikovRupert Redding-Jones
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Aug 24, 1999·BMJ : British Medical Journal·H A Kerstjens
Feb 24, 2001·American Journal of Respiratory and Critical Care Medicine·K A GriffithP L Enright
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Sep 18, 2009·Current Medical Research and Opinion·Barbara YawnGlenn Crater
Jan 14, 2009·Journal of Clinical Pharmacy and Therapeutics·T GuranE Dagli
Jul 13, 2001·Pulmonary Pharmacology & Therapeutics·C Owen

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