BMC Pulmonary Medicine (Nov 2024)

Update of prognosis and characteristics of chronic obstructive pulmonary disease in a real-world setting: a 5-year follow-up analysis of a multi-institutional registry

  • Tomotsugu Takano,
  • Kazuya Tsubouchi,
  • Naoki Hamada,
  • Katsuyuki Ichiki,
  • Ryo Torii,
  • Shohei Takata,
  • Satoru Kawakami,
  • Noriaki Nakagaki,
  • Makoto Yoshida,
  • Yasuhiko Kitasato,
  • Kazunori Tobino,
  • Eiji Harada,
  • Hiroshi Ishii,
  • Hiroshi Wataya,
  • Takashige Maeyama,
  • Masaki Fujita,
  • Kazuhiro Yatera,
  • Masaki Okamoto,
  • Hidetake Yabuuchi,
  • Fumiaki Kiyomi,
  • Shoji Tokunaga,
  • Yoichi Nakanishi,
  • Isamu Okamoto

DOI
https://doi.org/10.1186/s12890-024-03347-5
Journal volume & issue
Vol. 24, no. 1
pp. 1 – 10

Abstract

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Abstract Background We conducted a prospective observational study to elucidate the long-term prognosis and management of chronic obstructive pulmonary disease (COPD) in clinical practice in Japan in the mid-2010s. Methods This prospective cohort study included 29 facilities. Data from 427 patients clinically diagnosed with COPD, enrolled between September 2013 and April 2016, were analyzed. Interstitial pneumonia was excluded through a central multidisciplinary discussion. Follow-up data were collected for up to 5 years after patient registration. Results At the time of registration, 53 patients clinically diagnosed with COPD did not have airflow limitation (AFL). In the cohort with AFL (n = 374), 232 patients completed a 5-year follow-up, while 49 patients died during the 1576.6 person-years of observation. The mean age was 71.7 years with an overall 5-year survival rate of 85.4%. Stratified by % forced expiratory volume in one second (FEV1), survival rates were 93.6% in the mild and moderate AFL group, 82.5% in the severe AFL group, and 66.1% in the very severe AFL group. The prognosis of the subpopulation without AFL was poor with a 5-year survival of 81.6%. This subpopulation exhibited respiratory symptoms, low vital capacity and total lung capacity, and emphysematous changes. Conclusions Our study presents the 5-year survival and real-world clinical practice scenario of a prospective cohort of patients clinically diagnosed with COPD in Japan in the mid-2010s. The survival rates of our cohort were numerically better than the Japanese cohort in the 1990s, regardless of the high median age of this cohort. Overall, 12.4% of the patients in this cohort with no AFL at registration exhibited respiratory symptoms and distinct spirometric patterns, and had a poor prognosis.

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