Course and Prognosis of Chronic Obstructive Lung Disease

To document the course and prognosis of chronic obstructive lung disease, 200 patients with the disorder were enrolled in a prospective standardized study four to eight years ago. Their disease progressed in a more regular and more predictable fashion than had been anticipated from casual clinical observations. Reasonably precise predictions of longevity could be made on the basis of initial findings. Measurements of ventilatory capacity, resting heart rate and carbon dioxide levels were the best indicators of prognosis. Prediction of survival was further improved by consideration of the course of physiologic abnormalities over a two-year follow-up period. Most features of the disease showed a systematic tendency to worsen, but yearly changes were relatively small, often becoming evident only with long-term observation. Data are compatible with the concept that chronic obstructive lung disease is a slowly progressive disorder that begins many years before the onset of clinical symptoms.