Up-to-date on mortality in COPD - report from the OLIN COPD study

All subjects with COPD (n = 993) defined according to the GOLD spirometric criteria, FEV1/FVC < 0.70, and gender- and age-matched subjects without airway obstruction, non-COPD (n = 993), were identified in a clinical follow-up survey of the Obstructive Lung Disease in Northern Sweden (OLIN) Studies cohorts in 2002-2004. Mortality was observed until the end of year 2007. Baseline data from examination at recruitment were used in the risk factor analyses; age, smoking status, lung function (FEV1 % predicted) and reported heart disease.The mortality was significantly higher among subjects with COPD, 10.9%, compared to subjects without COPD, 5.8% (p < 0.001). Mortality was associated with higher age, being a current smoker, male gender, and COPD. Replacing COPD with FEV1 % predicted in the multivariate model resulted in the decreasing level of FEV1 being a significant risk factor for death, while heart disease was not a significant risk factor for death in any of the models.In this cohort COPD and decreased FEV1 were significant risk factors for death when adjusted for age, gender, smoking habits and reported heart disease.Chronic Obstructive Pulmonary Disease (COPD) is recognized as a major public health problem with an increasing morbidity and mortality. It has been forecasted that COPD will be ranked the fourth burden of disease worldwide by year 2030 [1]. The prevalence of COPD is most often reported in the range of 6-10% of the total adult population [2], it is strongly correlated to smoking and age, and about 50% of elderly smokers fulfil the spirometric criteria of COPD [3]. Population studies have shown that a large majority of COPD patients have mild-to-moderate disease [4].The underdiagnosis of COPD is well-known. Only about a third of all cases with COPD have been recognized by the health care [3-6], and the proportion of undiagnosed cases decreases with increasing disease severity [4]. Most reports on mortality in COPD are based on death certificates and hen