The online version of this article (doi:10.1186/1465-9921-15-30) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interest.
ME had full access to all the data in the study and takes full responsibility for the integrity of the data and the accuracy of the data analysis. Conception and design: ABH, ME, ZA; acquisition of data: BM, ME; analysis and interpretation of data: ABH, BM, KF, ME, ZA; drafting the article: ABH, ME, ZA; revision for important intellectual content and approval of the version to be published: ABH, BM, KF, ME, ZA. All authors read and approved the final manuscript.
The prognostic role of the arterial blood gas tension of carbon dioxide (PaCO2) in severe Chronic Obstructive Pulmonary Disease (COPD) remains unknown. The aim of this study was to estimate the association between PaCO2 and mortality in oxygen-dependent COPD.
National prospective study of patients starting long-term oxygen therapy (LTOT) for COPD in Sweden between October 1, 2005 and June 30, 2009, with all-cause mortality as endpoint. The association between PaCO2 while breathing air, PaCO2 (air), and mortality was estimated using Cox regression adjusted for age, sex, arterial blood gas tension of oxygen (PaO2), World Health Organization performance status, body mass index, comorbidity, and medications.
Of 2,249 patients included, 1,129 (50%) died during a median 1.1 years (IQR 0.6-2.0 years) of observation. No patient was lost to follow-up. PaCO2 (air) independently predicted adjusted mortality (p < 0.001). The association with mortality was U-shaped, with the lowest mortality at approximately PaCO2 (air) 6.5 kPa and increased mortality at PaCO2 (air) below 5.0 kPa and above 7.0 kPa.
In oxygen-dependent COPD, PaCO2 (air) is an independent prognostic factor with a U-shaped association with mortality.
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Karl A Franklin
Magnus P Ekström
- BioMed Central
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