Prognosis in Severe Chronic Obstructive Pulmonary Disease

The prognosis of 187 patients with severe chronic obstructive pulmonary disease has been evaluated by use of the life table method. All patients had a FEV 1 less than 60% of VC and below 1.5 1. The observation time ranged from 4 years and 4 months to 7 years and 4 months. The cumulative survival rate in the whole material was 71 % after 3 years and 47% after 6 ýears, results which are very close to the survival found by other authors. Calculations are presented of the survival of FEV 1 subgroups and of clinical functional groups separately and combined. These two classifications have a good correlation to survival, and it is demonstrated that the combination of functional group and FEV 1 subgroups adds more information regarding the prognosis than that obtained through FEV 1 alone. Among patients with earlier pulmonary tuberculosis the prognosis was related only to the degree of pulmonary obstruction. The expected increase in lethality with advancing age was demonstrated, but the mortality was relatively higher in the younger age group when compared to the general population of the same age. The prognosis of patients with cor pulmonale was considerably worse than of patients without cor pulmonale, even when the higher degree of severe airway obstruction was considered.