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COPD (Chronic Obstructive Pulmonary Disease)

Prognosis for severe emphysema.

11/16/2007

Question:

Six years ago I had a chest xray (for an unrelated illness) and was told then that I had emphysema advanced well beyond my years. I was 55 yrs. at that time and continued to smoke (I did quit in 2003). I had an MI in 2003 followed by CABG x 3. I have been on oxygen at 2 liters, 24 hrs. a day. I have congestive heart failure with a left ventricular ejection fraction of 37%. I recently had a CT scan and the radiologist report stated I had severe emphysema with partial collapse of both lungs. I am on Advair and Combivent. I have shortness of breath just walking across a room, and after a shower I have to sit awhile to recover. I recently told my Dr. that I was dieting to lose some weight and she suggested I not lose much, that I should have a reserve since I will be losing weight due to the emphysema. My question is simple, based on this information, could you suggest what the approximate life expectancy could be for someone in this state of health? I would really appreciate your consideration and response to this question. Thank you so much for any information you could give me.

Answer:

Based on the information you provide, the probability of surviving three years is about 50%. This estimate is based on an index published by Dr. Celli in the New England Journal of Medicine in 2004 (BODE index). Because you did not provide all of the necessary information, there are two important assumptions that this estimate is based on: 1) you have severe impairment on pulmonary function testing and 2) you can walk less than ~800 feet in six minutes.  It should be stressed that there is considerable variability in the life expectancy of individual patients with COPD, and it would not be uncommon for someone like you to live much longer than the three years quoted above.

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Response by:

Mahasti   Rittinger, RRT Mahasti Rittinger, RRT
Clinical Program Manager of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University

Phillip T Diaz, MD Phillip T Diaz, MD
Professor of Pulmonary, Allergy, Critical Care & Sleep Medicine
College of Medicine
The Ohio State University