Brief overview
- Factors influencing COPD life expectancy: one-second capacity (FEV1), nicotine use, worsening of the disease (exacerbation), age, concomitant diseases.
- Stage 4 life expectancy: depends on many factors such as lung function, physical condition, and behavior of the COPD patient.
- BODE index: assessment of COPD life expectancy, body mass index (BMI), lung function (FEV1), shortness of breath (dyspnea, MMRC scale), 6-minute walk test.
What is the life expectancy with COPD?
How long one lives with COPD (chronic obstructive pulmonary disease) depends on various influencing factors. Important factors include the one-second capacity, nicotine consumption, worsening of the disease (exacerbation), age and any concomitant diseases.
Please note: On the one hand, statistical information on life expectancy in COPD can be obtained by analyzing patient data – on the other hand, every course of the disease is different and so is the individual life expectancy.
The severity or stage of COPD (such as GOLD 1, 2, 3, 4) is not the only factor that physicians use to estimate life expectancy. Various factors, such as smoking, also influence the risk of dying prematurely from the consequences of the disease.
One-second capacity
One factor influencing COPD life expectancy is the one-second capacity (FEV1). This is the largest possible lung volume that one exhales within one second under exertion.
If the one-second capacity is still more than 1.25 liters, the average life expectancy is about ten years. Patients with an FEV1 between 0.75 and 1.25 liters have a life expectancy of about five years. With a one-second capacity below 0.75 liters, life expectancy is about three years.
Smoking cessation
Quitting smoking early has a life-prolonging effect. According to the American Cancer Society, the life expectancy of smokers is generally at least ten years shorter than that of non-smokers.
If smoking is successfully stopped before the age of 40, the risk of dying from diseases such as COPD, which are often a consequence of smoking, is reduced by 90 percent. Those who stop smoking even earlier benefit even more in terms of health.
Experts recommend that COPD patients give up cigarettes and other tobacco products to halt the progression of the disease and thus live as long as possible.
Exacerbations
Exacerbations are acute worsening of COPD symptoms. Any acute exacerbation of chronic obstructive pulmonary disease (AECOPD) shortens life expectancy in COPD patients.
Age and concomitant diseases
Certain factors favor a severe course of the disease and thus reduce COPD life expectancy. For example, if the affected person has an advanced age or if there is another serious concomitant disease such as heart failure or diabetes mellitus, a worsening is likely.
Increased levels of carbon dioxide in the blood (hypercapnia) or previous long-term therapy with oral steroids also sometimes have a negative impact on COPD life expectancy.
What is the life expectancy at stage 4?
The stage of the disease alone does not say much about the life expectancy of a COPD patient. To a large extent, life expectancy depends on the degree of damage to the lungs (lung function) and the body as a whole. The behavior of the affected person (smoking, exercise, diet, etc.) also has a strong influence on life expectancy.
Experts suggest that the life of a COPD patient is shortened by an average of five to seven years (across all stages). However, this depends on the influencing factors mentioned above. Researchers have found, for example, that the life expectancy of stage 4 COPD patients who smoke is shortened by up to nine years on average.
Whether you live to a ripe old age with COPD therefore depends on many different factors. What is certain is that you as a patient sometimes have a great influence on life expectancy with COPD.
BODE index
The BODE index helps to estimate a patient’s expected COPD life expectancy: Patients with a high BODE index of ten or less have a low life expectancy. Patients with a value of zero have the lowest mortality risk.
Four easily determined parameters are included in the BODE index:
- B for “Body Mass Index”: The BMI is calculated from height and weight.
- O for “Obstruction”: The physician determines the lung function on the basis of the one-second capacity (FEV1).
- D for “Dyspnea”: The physician measures shortness of breath using the Modified Medical Research Council Dyspnea Scale (MMRC scale).
- E for “Exercise capacity”: The physical capacity is measured with the 6-minute walking test. The patient walks on level ground for six minutes. A healthy adult covers an average of 700 to 800 meters, a COPD patient less, depending on fitness.
MMRC grades, the extent of the patient’s shortness of breath, are defined as follows:
|
MMRC grade 0 |
Dyspnea during heavy exertion |
|
MMRC Grade 1 |
Dyspnea on fast walking or on gentle inclines |
|
MMRC grade 2 |
Walking slower than peers due to dyspnea |
|
MMRC grade 3 |
|
|
MMRC Grade 4 |
Dyspnea on dressing/dressing |
Points are awarded for each parameter of the BODE index:
|
Parameter |
Points |
|||
|
0 |
1 |
2 |
3 |
|
|
BMI (kg/m²) |
>21 |
≤21 |
||
|
One-second capacity, FEV1 (% of target). |
>65 |
50 – 64 |
36 – 49 |
≥35 |
|
Shortness of breath, MMRC |
0-1 |
2 |
3 |
4 |
|
6-minute walk test (m) |
>350 |
250 – 349 |
150 – 249 |
≤149 |
The physician calculates a patient’s BODE index by adding the scores of the individual parameters. From this, he then derives the presumed COPD life expectancy.
