000147812 001__ 147812
000147812 005__ 20250107161405.0
000147812 0247_ $$2doi$$a10.1016/j.chest.2021.04.033
000147812 0248_ $$2sideral$$a127835
000147812 037__ $$aART-2021-127835
000147812 041__ $$aeng
000147812 100__ $$ade-Torres, J.P.
000147812 245__ $$aClinical and Prognostic Impact of Low Diffusing Capacity for Carbon Monoxide Values in Patients With Global Initiative for Obstructive Lung Disease I COPD
000147812 260__ $$c2021
000147812 5060_ $$aAccess copy available to the general public$$fUnrestricted
000147812 5203_ $$aBackground: The Global Initiative for Obstructive Lung Disease (GOLD) does not promote diffusing capacity for carbon monoxide (DLCO) values in the evaluation of COPD. In GOLD spirometric stage I COPD patients, the clinical and prognostic impact of a low DLCO has not been explored. Research Question: Could a DLCO threshold help define an increased risk of death and a different clinical presentation in these patients? Study Design and Methods: GOLD stage I COPD patients (n = 360) were enrolled and followed over 109 ± 50 months. Age, sex, pack-years’ history, BMI, dyspnea, lung function measurements, exercise capacity, BODE index, and history of exacerbations were recorded. A cutoff value for DLCO was identified for all-cause mortality and the clinical and physiological characteristics of patients above and below the threshold compared. Cox regression analysis explored the predictive power of that cutoff value for all-cause mortality. Results: A DLCO cutoff value of <60% predicted was associated with all-cause mortality (DLCO = 60%: 9% vs DLCO < 60%: 23%, P = .01). At a same FEV1% predicted and Charlson score, patients with DLCO < 60% had lower BMI, more dyspnea, lower inspiratory capacity (IC)/total lung capacity (TLC) ratio, lower 6-min walk distance (6MWD), and higher BODE. Cox multiple regression analysis confirmed that after adjusting for age, sex, pack-years history, smoking status, and BMI, a DLCO < 60% is associated with all-cause mortality (hazard ratio [HR], 95% CI = 3.37, 1.35-8.39; P = .009) Interpretation: In GOLD I COPD patients, a DLCO < 60% predicted is associated with increased risk of death and worse clinical presentation. What the cause(s) of this association are and whether they can be treated need to be determined. © 2021 American College of Chest Physicians
000147812 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc-nd$$uhttp://creativecommons.org/licenses/by-nc-nd/3.0/es/
000147812 590__ $$a11.393$$b2021
000147812 591__ $$aCRITICAL CARE MEDICINE$$b5 / 35 = 0.143$$c2021$$dQ1$$eT1
000147812 591__ $$aRESPIRATORY SYSTEM$$b6 / 66 = 0.091$$c2021$$dQ1$$eT1
000147812 592__ $$a2.264$$b2021
000147812 593__ $$aCritical Care and Intensive Care Medicine$$c2021$$dQ1
000147812 593__ $$aCardiology and Cardiovascular Medicine$$c2021$$dQ1
000147812 594__ $$a10.0$$b2021
000147812 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000147812 700__ $$aO'Donnell, D.E.
000147812 700__ $$0(orcid)0000-0001-9096-2294$$aMarín, J.M.$$uUniversidad de Zaragoza
000147812 700__ $$aCabrera, C.
000147812 700__ $$aCasanova, C.
000147812 700__ $$aMarín, M.
000147812 700__ $$aEzponda, A.
000147812 700__ $$aCosio, B.G.
000147812 700__ $$aMartinez, C.
000147812 700__ $$aSolanes I.
000147812 700__ $$aFuster A.
000147812 700__ $$aNeder J.A.
000147812 700__ $$aGonzalez-Gutierrez, J.
000147812 700__ $$aCelli, B.R.
000147812 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000147812 773__ $$g160, 3 (2021), 872-878$$pChest$$tChest$$x0012-3692
000147812 8564_ $$s297347$$uhttps://zaguan.unizar.es/record/147812/files/texto_completo.pdf$$yVersión publicada
000147812 8564_ $$s2119838$$uhttps://zaguan.unizar.es/record/147812/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000147812 909CO $$ooai:zaguan.unizar.es:147812$$particulos$$pdriver
000147812 951__ $$a2025-01-07-14:05:31
000147812 980__ $$aARTICLE