Millions of adults around the world suffer from chronic obstructive pulmonary disease (COPD), and an equal number are at risk of developing it. According to the National Heart, Lung, and Blood Institute, however, many of them are unaware.
How long can I live with COPD?
There is no way to predict a person’s exact life expectancy, but having this progressive lung disease can shorten one’s life. The extent to which this is true is determined by your overall health and whether you have other diseases such as heart disease or diabetes.
The GOLD system
Over the years, researchers have developed a method to assess the health of someone suffering from COPD. One of the most recent methods combines the results of a spirometry lung function test with a person’s symptoms. These produce labels that can help predict life expectancy and guide treatment decisions in COPD patients.
The Global Initiative for Chronic Obstructive Lung Disease (GOLD) is one of the most widely used classification systems for COPD. GOLD is an international group of lung health experts who produce and update guidelines for doctors to use in the care of people with COPD on a regular basis.
Doctors use the GOLD system to assign “grades” of COPD to patients. Grading is a method of determining the severity of a condition. It categorizes the severity of COPD using the forced expiratory volume (FEV1), a test that determines how much air a person can forcefully exhale from their lungs in one second.
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The most recent guidelines include FEV1 in the evaluation. You receive a GOLD grade or stage based on your FEV1 score as follows:
GOLD 1: FEV1 of 80% or higher predicted
GOLD 2: predicted FEV1 of 50 to 79 percent
GOLD 3: predicted FEV1 of 30 to 49 percent
GOLD 4: FEV1 less than 30% of predicted
The second part of the evaluation is based on symptoms such as dyspnea, or difficulty breathing, as well as the severity and number of acute exacerbations, which are flare-ups that may necessitate hospitalization.
People with COPD will be classified into one of four groups based on these criteria: A, B, C, or D.
Someone in group A or B would have had no exacerbations or required hospitalization in the previous year. An evaluation of breathing symptoms will also determine this. Those with more symptoms are in group B, while those with fewer symptoms are in group A.
People in Group C or D had at least one exacerbation that required hospitalization, or at least two exacerbations that did or did not require hospitalization in the previous year. Those with more breathing symptoms would be placed in Group D, while those with fewer symptoms would be placed in group C.
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According to the new guidelines, someone labeled GOLD Grade 4, Group D, has the most severe form of COPD. They will also have a shorter life expectancy than someone with a GOLD Grade 1, Group A label.
The BODE index
The BODE index is another measure that uses more than just the FEV1 to assess a person’s COPD condition and outlook. BODE is an acronym that stands for:
- body weight
- airflow impediment
- dyspnea
- capacity for exercise
BODE examines how COPD affects your life as a whole. Although some physicians use the BODE index, its value may be diminishing as researchers learn more about the disease.
Body weight
The body mass index (BMI), which measures body mass based on height and weight parameters, can help determine whether a person is overweight or obese. BMI can also tell you if you’re too thin. People with COPD who are too thin may have a poor prognosis.
Airflow impediment
As in the GOLD system, this refers to the FEV1.
Dyspnea
Previous research suggests that breathing difficulties can have an impact on the prognosis of COPD.
Capability to exercise
This refers to how well you tolerate exercise. It is frequently measured by a test known as the “6-minute walk test.”
Blood test on a regular basis
Systemic inflammation is a key feature of COPD. A blood test that looks for inflammation markers could be beneficial.
According to a study published in the International Journal of Chronic Obstructive Pulmonary Disease, the neutrophil-to-lymphocyte ratio (NLR) and eosinophil-to-basophil ratio (EBR) have a significant correlation with the severity of COPD.
According to the article, COPD patients can measure these markers using a routine blood test. It was also mentioned that the NLR could be particularly useful as a predictor of life expectancy.
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Rates of mortality
As with any serious disease, such as COPD or cancer, the likelihood of survival is largely determined by the severity or stage of the disease.
A 65-year-old man with COPD who currently smokes tobacco, for example, has the following reductions in life expectancy, depending on the stage of COPD, according to a 2009 study published in the International Journal of Chronic Obstructive Pulmonary Disease:
0.3 years for the first stage
2.2 years for stage 2
5.8 years for stages 3 or 4
The study also stated that this group lost an additional 3.5 years to smoking when compared to those who never smoked and did not have lung disease.
COPD reduces life expectancy in ex-smokers as follows:
1.4 years for stage 2
5.6 years for stages 3 or 4
The article also stated that this group lost an additional 0.5 years to smoking when compared to those who never smoked and did not have lung disease.
The reduction in life expectancy for those who never smoked is:
0.7 years for stage 2
1.3 years for stages 3 or 4
In comparison to current smokers, the difference in life expectancy for former smokers and those who have never smoked was not as significant for those at stage 0 and those at stage 1.
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