Relation of FEV1 to clinical outcomes during exacerbations of chronic obstructive pulmonary disease

Dennis E. Niewoehner, Dorothea Collins, Marcia L. Erbland

Research output: Contribution to journalArticlepeer-review

74 Scopus citations

Abstract

FEV1 is an objective measure of airflow obstruction used in clinical practice and in therapeutic trials. The precise relationship of FEV1 to clinical outcomes is generally uncertain. As part of a randomized trial to assess systemic corticosteroid efficacy, we obtained serial FEV1 measurements in patients hospitalized for exacerbations of chronic obstructive pulmonary disease (COPD). Over the first 14 Study Days at least one FEV1 value was obtained in 261 subjects. Sixty-four of these subjects experienced treatment failure, defined as death, intubation, readmission for COPD, or intensification of drug therapy, by Study Day 30. After adjustment, both FEV1 at entry into the study (odds ratio [OR] for a 100-ml increase, 0.87; 95% confidence interval [CI], 0.79 to 0.96) and change in FEV1 over the first two Study Days (OR for a 100 ml increase, 0.80; 95% CI, 0.69 to 0.92) predicted treatment failure. We identified no baseline characteristic that was significantly related to FEV1 at entry into the study. Assignment to the systemic corticosteroid treatment arm was associated with a significantly larger FEV1 at Study Day two (p = 0.01). We conclude that FEV1 measurements at admission and over the first several days of hospitalization are highly predictive of clinical outcomes during exacerbations of COPD.

Original languageEnglish (US)
Pages (from-to)1201-1205
Number of pages5
JournalAmerican journal of respiratory and critical care medicine
Volume161
Issue number4 I
DOIs
StatePublished - Jan 1 2000

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