Life Expectancy With COPD - Safey Medical Devices
The life expectancy of a person with COPD or Asthma is a subject not widely or favourably discussed, but it is an important issue to be aware of. Learn more!
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The life expectancy of a person with chronic obstructive pulmonary disease or COPD is a subject not widely or favourably discussed, but it is an important issue to be aware of. Take a look at grading systems and stages of severity associated with this incurable condition
Chronic obstructive pulmonary disease or COPD is an umbrella term used to cover a range of health conditions, affecting a person’s otherwise healthy lungs. As the name itself would suggest, it is a chronic condition for those who have been diagnosed.
NICE
– The National Institute for Health and Care Excellence –
explain this chronic condition as:
“COPD is characterized by airflow obstruction that is not fully reversible. The airflow obstruction does not change markedly over several months and is usually progressive in the long term. COPD is predominantly caused by smoking. Other factors, particularly occupational exposures, may also contribute to the development of COPD. Exacerbations often occur, where there is a rapid and sustained worsening of symptoms beyond normal day-to-day variations.”
One of the main issues that COPD poses is that it causes airflow obstruction. Due to this blockage, it impacts the flow of oxygen into a person’s lungs, therefore unable to move around the body effectively.
Oxygen is the very thing we need to keep us going, and so in extreme cases of COPD, it can indeed prove fatal.
And one of the worst offenders? Exposure to toxic cigarette smoke.
According to Professor Dame Sally Davies, Chief Medical Officer, nearly 90% of these COPD deaths are linked to smoking. Causing irreparable damage to the lungs, currently, there is no cure for COPD.
And despite the statistics showing that less and less people are smoking in today’s times, the number of patients suffering with such a debilitating lung condition is soaring still.
One such theory for this rise is to do with possible genetics dating back through the generations. In a recent study conducted by the Los Angeles Biomedical Research Institute, lead researcher, Dr. Virender K. Rehan stated:
“There is strong evidence that these alterations in the structure and function of the lung caused by nicotine exposure during pregnancy can also be passed from one generation to the next.”
So with this in mind, what is the prognosis for people who have been diagnosed with this debilitating condition?
GOLD system
A shining beacon of hope, in recent times, researchers have invented a way to assess the health of a COPD sufferer. How? The ingenious GOLD system.
This pioneering method brings together a person’s lung function test results with their symptoms in order to produce labels predicting a person’s life expectancy.
Why GOLD? It stands for “The Global Initiative for Chronic Obstructive Lung Disease”. These are the clever brains who devised such a system.
As an international group of lung health experts who periodically produce guidelines for doctors to use in the care of people with COPD and other lung diseases, GOLD is golden when it comes to assessing disease “stages” in relation to life expectancy of those with COPD.
And why assess in stages? As a way to measure the severity of COPD, the GOLD system uses your forced expiratory volume (FEV1) test from your pulmonary function test, The Lung Institute explains.
FEV1 may sound a little intimidating, but it simply means the amount of air you can forcefully exhale or breathe out, in one whole second.
Normal FEV1 values vary between individuals, and can depend on the following factors:
Age Gender Height Race
As the severity of COPD changes over time, and your COPD symptoms begin to worsen, the stage number allocated shows just how limited the airflow is and shows an indication of life expectancy
The FEV1 test determines the amount of air a person can forcefully exhale in one entire second as a way to categorise the severity of COPD.
To put it simply, the GOLD COPD stages break down into 4 eventual stages. Over time, COPD symptoms will worsen, and the stage numbers will increase.
The most recent guidelines see FEV1 as a crucial part of the assessment.
Based on your own FEV1 score, you will then receive a GOLD stage as below:
GOLD1: FEV1 of 80 percentor more
GOLD 2: FEV1 of 50 to 79 percent
GOLD 3: FEV1 of 30 to 49 percent
GOLD 4: FEV1 of less than 30 percent
As an example of this staging system, one study showed a 10-year survival probability amongst smokers compared to persons with no lung disease. They found that this probability rate was 75%, compared with 65% for persons with COPD symptoms, 63% for stage 1, 58% for stage 2, and approximately 15% for stage 3 or 4.
It’s important to understand that your FEV1 score alone is not an effective way to diagnose COPD. This diagnosis requires the need for a specific calculation involving both FEV1 and another breathing measurement called forced vital capacity or FVC.
This measurement is essentially the greatest amount of air you can forcefully exhale once you’ve taken the deepest breathe you possibly can.
If your doctor suspects that you have COPD, they’ll calculate your FEV1/FVC ratio, working out the overall percentage of your individual lung capacity.
The higher your percentage, the larger your lung capacity and the healthier your lungs.
COPD is diagnosed if your FEV1/FVC ratio drops under 70% of the predicted value.
Your doctor usually uses a COPD set of questions as a form of assessment.
These questions look at the way in which it affects your life.They help to calculate the grade and subsequent severity of your condition.
The second part of the GOLD assessment looks at other symptoms such as
dyspnea – laboured or difficult breathing –
and flare-ups, known in the healthcare world as exacerbations.
These may be triggered by an infection and usually require hospitalisation.
According to the British Lung Foundation (BLF), these can include:
- Breathlessness getting worse
- A cough that becomes more frequent
- you produce more sputum
- An increase in the volume or a change in the colour and consistency of your sputum
When these criteria are looked at, those who have been diagnosed with COPD will be placed into one of four groups in relation to life expectancy:
A B C D
A or B
Someone who has experience zero exacerbations or one didn’t see them admitted to A&E in the past year would be in Group A or B. This will also depend on an assessment of their breathing.
C or D
People with at least one exacerbation that did require a hospital visit or at least two exacerbations in the past year, would fall into Group C or D.
Under the new guidelines, someone who suffers with COPD and is flagged as a GOLD Grade 4, Group D, would be classified as the most serious cases of COPD.
Their outlook will be worse than other COPD sufferers and this means they will have a shorter life expectancy than someone with a label at the other end of the grading system: GOLD Grade 1, Group A.
BODE Index
There is another way to assess a COPD sufferer’s outlook, and that’s with the BODE Index.
This method also uses more than just the FEV1 to in order to measure a person’s condition and prognosis.
Predicting survival in COPD patients, BODE stands for:
- Body mass
- airflow Obstruction
- Dyspnea
- Exercise capacity
BODE takes into account an overall picture of how COPD affects your life. Though the BODE Index is used by physicians, its value in predicting the course of the disease and life expectancy may be lessening as researchers learn more about the disease.
Body mass
The body mass index, more commonly used by doctors as BMI can determine if a person is obese or too thin. You may be surprised to learn that people who are diagnosed as too thin have a worse outlook.
Airflow Obstruction
This refers to the FEV1.
Dyspnea
Some studies have shown that people who experience more difficulties with their breathing – dyspnea – have a lower rate of survival than those who don’t.
Exercise capacity
Simply put, this is how well you can tolerate exercise.
It can be measured with something known as the “6-minute walk test.”
The BODE Index offers further information on COPD survival figures here:
Routine blood test
As studies show that COPD is independently associated with low-grade systemic inflammation, a blood test that checks for certain markers of inflammation can be a useful aid in when looking at life expectancy.
A 2016 study published in the International Journal of Chronic Obstructive Pulmonary Disease shows that parameters such as neutrophil-to-lymphocyte ratio (NLR) and eosinophil-to-basophil ratio (EBR) within a routine blood test – also known as RBT – are considered to be the underlying biomarkers of inflammation.
This make its a good predictor for COPD life expectancy.
