000063338 001__ 63338
000063338 005__ 20171129112118.0
000063338 0247_ $$2doi$$a10.1371/journal.pone.0089866
000063338 0248_ $$2sideral$$a100112
000063338 037__ $$aART-2014-100112
000063338 041__ $$aeng
000063338 100__ $$aAlmagro, P.
000063338 245__ $$aFinding the best thresholds of FEV1and dyspnea to predict 5-year survival in COPD patients: The COCOMICS study
000063338 260__ $$c2014
000063338 5060_ $$aAccess copy available to the general public$$fUnrestricted
000063338 5203_ $$aBackground: FEV1 is universally used as a measure of severity in COPD. Current thresholds are based on expert opinion and not on evidence. Objectives: We aimed to identify the best FEV1 (% predicted) and dyspnea (mMRC) thresholds to predict 5-yr survival in COPD patients. Design and Methods: We conducted a patient-based pooled analysis of eleven COPD Spanish cohorts (COCOMICS). Survival analysis, ROC curves, and C-statistics were used to identify and compare the best FEV1 (%) and mMRC scale thresholds that predict 5-yr survival. Results: A total of 3, 633 patients (93% men), totaling 15, 878 person-yrs. were included, with a mean age 66.4±9.7, and predicted FEV1 of 53.8% (±19.4%). Overall 975 (28.1%) patients died at 5 years. The best thresholds that spirometrically split the COPD population were: mild =70%, moderate 56-69%, severe 36-55%, and very severe =35%. Survival at 5 years was 0.89 for patients with FEV1=70 vs. 0.46 in patients with FEV1 =35% (H.R: 6; 95% C.I.: 4.69-7.74). The new classification predicts mortality significantly better than dyspnea (mMRC) or FEV1 GOLD and BODE cutoffs (all p<0.001). Prognostic reliability is maintained at 1, 3, 5, and 10 years. In younger patients, survival was similar for FEV1 (%) values between 70% and 100%, whereas in the elderly the relationship between FEV1 (%) and mortality was inversely linear. Conclusions: The best thresholds for 5-yr survival were obtained stratifying FEV1 (%) by =70%, 56-69%, 36-55%, and =35%. These cutoffs significantly better predict mortality than mMRC or FEV1 (%) GOLD and BODE cutoffs.
000063338 536__ $$9info:eu-repo/grantAgreement/ES/MICINN/MTM2011-23204
000063338 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/
000063338 590__ $$a3.234$$b2014
000063338 591__ $$aMULTIDISCIPLINARY SCIENCES$$b9 / 57 = 0.158$$c2014$$dQ1$$eT1
000063338 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000063338 700__ $$aMartinez-Camblor, P.
000063338 700__ $$aSoriano, J. B.
000063338 700__ $$0(orcid)0000-0001-9096-2294$$aMarin, J. M.$$uUniversidad de Zaragoza
000063338 700__ $$aAlfageme, I.
000063338 700__ $$aCasanova, C.
000063338 700__ $$aEsteban, C.
000063338 700__ $$aSoler-Cataluña, J. J.
000063338 700__ $$aDe-Torres, J.
000063338 700__ $$aCelli, B. R.
000063338 700__ $$aMiravitlles, M.
000063338 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDepartamento de Medicina, Psiquiatría y Dermatología$$cMedicina
000063338 773__ $$g9, 2 (2014), e89866 [7 pp]$$pPLoS One$$tPLoS One$$x1932-6203
000063338 8564_ $$s230570$$uhttps://zaguan.unizar.es/record/63338/files/texto_completo.pdf$$yVersión publicada
000063338 8564_ $$s115787$$uhttps://zaguan.unizar.es/record/63338/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000063338 909CO $$ooai:zaguan.unizar.es:63338$$particulos$$pdriver
000063338 951__ $$a2017-11-28-13:52:01
000063338 980__ $$aARTICLE