Unique Mortality Profile in Japanese Patients with COPD: An Analysis from the Hokkaido COPD Cohort Study

Abstract

Purpose

Causes of death may be unique and different in Japanese patients with COPD because they are generally older, thinner, experience fewer exacerbations, and live longer than those in other countries. We investigated the detailed mortality profile in the Hokkaido COPD cohort study, which completed a 10-year follow-up with a very low dropout rate.

Patients and Methods

We prospectively examined the 10-year natural history in 279 Japanese patients with COPD (GOLD 1, 26%; GOLD 2, 45%; GOLD 3, 24%; and GOLD 4, 5%). The majority of patients were male, and the average age at baseline was 69 years old. About 95% of all patients had accurate mortality data. The risk factors for mortality were also analyzed.

Results

During the 10 years, 112 patients (40%) died. Their median survival time was 6.1 years (interquartile range: 4.7–7.9 years), and age at death was 79 ± 6 years old (mean ± SD). Respiratory diseases, including pneumonia, were the leading causes of death in 45 (40%), followed by lung cancer in 24 (21%), other cancers in 18 (16%), and cardiovascular diseases in 12 (11%). In particular, lung cancer-related death was equally distributed across all COPD stages, with a higher proportion of lung cancer in the relatively younger generation (<64 years old). Older age at baseline, lower BMI, and severer emphysema were significant risk factors for all-cause mortality.

Conclusion

The unique mortality profile observed in this study should be considered when designing strategies for the management of patients with COPD in any geographic region.

Journal

Journal ID (nlm-ta): Int J Chron Obstruct Pulmon Dis

Journal ID (iso-abbrev): Int J Chron Obstruct Pulmon Dis

Journal ID (publisher-id): copd

Journal ID (pmc): copd

Title: International Journal of Chronic Obstructive Pulmonary Disease

Publisher: Dove

ISSN (Print): 1176-9106

ISSN (Electronic): 1178-2005

Publication date (Electronic): 04 September 2020

Publication date Collection: 2020

Volume: 15

Pages: 2081-2090

Affiliations

[1 ]Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University , Sapporo, Japan

[2 ]Hokkaido Medical Research Institute for Respiratory Diseases , Sapporo, Japan

[3 ]Center for Respiratory Diseases, JCHO Hokkaido Hospital , Sapporo, Japan

[4 ]Department of Internal Medicine, KKR Sapporo Medical Center , Sapporo, Japan

[5 ]Department of Internal Medicine, Hokkaido Chuo Rosai Hospital , Iwamizawa, Japan

[6 ]Department of Respiratory Medicine, Otaru Kyokai Hospital , Otaru, Japan

Author notes

Correspondence: Masaharu Nishimura Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University , Sapporo, JapanTel [phone]Fax [phone] Email [e-mail]

[*]

These authors contributed equally to this work

Article

Publisher ID: 264437

DOI: 10.2147/COPD.S264437

PMC ID: 7481303

Copyright statement: © 2020 Makita et al.

License:

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Page count

Figures: 3, Tables: 9, References: 29, Pages: 10

Categories

Subject: Original Research