Clinical, physiologic, and radiographic factors contributing to development of hypoxemia in moderate to severe COPD: a cohort study

J Michael Wells; Raul San Jose Estepar; Merry-Lynn N McDonald; Surya P Bhatt; Alejandro A Diaz; William C Bailey; Francine L Jacobson; Mark T Dransfield; George R Washko; Barry J Make; Richard Casaburi; Edwin J R van Beek; Eric A Hoffman; Frank C Sciurba; James D Crapo; Edwin K Silverman; Craig P Hersh

doi:10.1186/s12890-016-0331-0

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Clinical, physiologic, and radiographic factors contributing to development of hypoxemia in moderate to severe COPD: a cohort study

Journal article

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Peer reviewed

Clinical, physiologic, and radiographic factors contributing to development of hypoxemia in moderate to severe COPD: a cohort study

J Michael Wells, Raul San Jose Estepar, Merry-Lynn N McDonald, Surya P Bhatt, Alejandro A Diaz, William C Bailey, Francine L Jacobson, Mark T Dransfield, George R Washko, Barry J Make, …

BMC pulmonary medicine, Vol.16(1), pp.169-169

12/01/2016

DOI: 10.1186/s12890-016-0331-0

PMCID: PMC5131397

PMID: 27903260

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Abstract

Hypoxemia is a major complication of COPD and is a strong predictor of mortality. We previously identified independent risk factors for the presence of resting hypoxemia in the COPDGene cohort. However, little is known about characteristics that predict onset of resting hypoxemia in patients who are normoxic at baseline. We hypothesized that a combination of clinical, physiologic, and radiographic characteristics would predict development of resting hypoxemia after 5-years of follow-up in participants with moderate to severe COPD METHODS: We analyzed 678 participants with moderate-to-severe COPD recruited into the COPDGene cohort who completed baseline and 5-year follow-up visits and who were normoxic by pulse oximetry at baseline. Development of resting hypoxemia was defined as an oxygen saturation ≤88% on ambient air at rest during follow-up. Demographic and clinical characteristics, lung function, and radiographic indices were analyzed with logistic regression models to identify predictors of the development of hypoxemia. Forty-six participants (7%) developed resting hypoxemia at follow-up. Enrollment at Denver (OR 8.30, 95%CI 3.05-22.6), lower baseline oxygen saturation (OR 0.70, 95%CI 0.58-0.85), self-reported heart failure (OR 6.92, 95%CI 1.56-30.6), pulmonary artery (PA) enlargement on computed tomography (OR 2.81, 95%CI 1.17-6.74), and prior severe COPD exacerbation (OR 3.31, 95%CI 1.38-7.90) were independently associated with development of resting hypoxemia. Participants who developed hypoxemia had greater decline in 6-min walk distance and greater 5-year decline in quality of life compared to those who remained normoxic at follow-up. Development of clinically significant hypoxemia over a 5-year span is associated with comorbid heart failure, PA enlargement and severe COPD exacerbation. Further studies are needed to determine if treatments targeting these factors can prevent new onset hypoxemia. COPDGene is registered at ClinicalTrials.gov: NCT00608764 (Registration Date: January 28, 2008).

Comorbidity

Quality of Life

United States

Severity of Illness Index

Multivariate Analysis

Prospective Studies

Cross-Sectional Studies

Humans

Middle Aged

Oximetry

Risk Factors

Logistic Models

Male

Tomography, X-Ray Computed

Pulmonary Disease, Chronic Obstructive - physiopathology

Pulmonary Disease, Chronic Obstructive - complications

Disease Progression

Hypoxia - epidemiology

Rest

Female

Aged

Walk Test

Heart Failure - epidemiology

Details

Title: Subtitle: Clinical, physiologic, and radiographic factors contributing to development of hypoxemia in moderate to severe COPD: a cohort study
Creators: J Michael Wells - , 1900 University Blvd, THT 422, Birmingham, AL, 35294, USA. jmwells@uabmc.edu
Raul San Jose Estepar - Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA
Merry-Lynn N McDonald - Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
Surya P Bhatt - Lung Health Center University of Alabama Birmingham, Birmingham, AL, USA
Alejandro A Diaz - Division of Pulmonary Medicine, Brigham and Women's Hospital, Boston, MA, USA
William C Bailey - Lung Health Center University of Alabama Birmingham, Birmingham, AL, USA
Francine L Jacobson - Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA
Mark T Dransfield - Birmingham VA Medical Center, Birmingham, AL, USA
George R Washko - Division of Pulmonary Medicine, Brigham and Women's Hospital, Boston, MA, USA
Barry J Make - Division of Pulmonary, Critical Care, and Sleep Medicine, National Jewish Health, Denver, CO, USA
Richard Casaburi - Rehabilitation Clinical Trials Center, Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, Torrance, CA, USA
Edwin J R van Beek - Department of Radiology, University of Edinburgh, Edinburgh, Scotland, UK
Eric A Hoffman - Department of Radiology, University of Iowa, Iowa City, IA, USA
Frank C Sciurba - Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA
James D Crapo - Division of Pulmonary, Critical Care, and Sleep Medicine, National Jewish Health, Denver, CO, USA
Edwin K Silverman - Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
Craig P Hersh - Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
Resource Type: Journal article
Publication Details: BMC pulmonary medicine, Vol.16(1), pp.169-169
DOI: 10.1186/s12890-016-0331-0
PMID: 27903260
PMCID: PMC5131397
NLM abbreviation: BMC Pulm Med
ISSN: 1471-2466
eISSN: 1471-2466
Publisher: England
Grant note: K01 HL118714 / NHLBI NIH HHS R01 HL116931 / NHLBI NIH HHS K08 HL123940 / NHLBI NIH HHS R01 HL125583 / NHLBI NIH HHS R01 HL089856 / NHLBI NIH HHS S10 OD018526 / NIH HHS UL1 TR001417 / NCATS NIH HHS KL2 TR001419 / NCATS NIH HHS R01 HL089897 / NHLBI NIH HHS R01 HL094635 / NHLBI NIH HHS R01 HL116473 / NHLBI NIH HHS
Language: English
Date published: 12/01/2016
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiology; Internal Medicine
Record Identifier: 9984051710502771

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