Changes in FEV1 over time in COPD

January 01, 0001

Changes in FEV1 over time in COPD

A key feature of chronic obstructive pulmonary disease (COPD) is an accelerated rate of decline in forced expiratory volume in 1 second (FEV1). These authors from multiple countries analyzed the changes in FEV1 after administration of a bronchodilator over a 3-year period in 2163 patients. They evaluated possible predictors of both FEV1 levels and their changes over time.

They found: "The mean rate of change in FEV1 was a decline of 33 ml per year, with significant variation among the patients studied. The between- patient standard deviation for the rate of decline was 59 ml per year. Over the 3-year study period, 38% of patients had an estimated decline in FEV1 of more than 40 ml per year, 31% had a decline of 21 to 40 ml per year, 23% had a change in FEV1 that ranged from a decrease of 20 ml per year to an increase of 20 ml per year, and 8% had an increase of more than 20 ml per year. The mean rate of decline in FEV1 was 21 ml per year greater in current smokers than in current nonsmokers, 13 ml per year greater in patients with emphysema than in those without emphysema, and 17 ml per year greater in patients with bronchodilator reversibility than in those without reversibility."

The authors concluded: "The rate of change in FEV1 among patients with COPD is highly variable, with increased rates of decline among current smokers, patients with bronchodilator reversibility, and patients with emphysema."

This information can be helpful in discussing prognosis of COPD with patients.


For the full abstract, click here.

N Engl J Med 365:1184-1192, 29 September 2011 © 2011 to the Massachusetts Medical Society
Changes in Forced Expiratory Volume in 1 Second over Time in COPD. Jørgen Vestbo, Lisa D. Edwards, Paul D. Scanlon, et al. Correspondence to Dr. Vestbo: jvestbo@dadlnet.dk

Category: R. Respiratory. Keywords: chronic obstructive pulmonary disease, COPD, forced expiratory volume in one second, FEV1, bronchodilator, smoking, prognosis, prospective cohort study, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 11 October 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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