P117 Rate of FEV1 decline in a primary care UK chronic obstructive pulmonary disease (COPD) population. (December 2018)

• Record Type: Journal Article
• Authors: Whittaker, HR; Müllerová, H; Jarvis, D; Quint, JK; Kiddle, S
• Is Part Of: Thorax. Volume 73(2018)Supplement 4
• Page Start: A164
• Page End: A165
• Publication Date: 2018-12
• Subjects: Chest -- Diseases -- Periodicals; Thorax; Chest -- Diseases; Periodicals; Periodicals; 617.54
• DOI: 10.1136/thorax-2018-212555.275
• Languages: English
• ISSNs: 0040-6376

Abstract

Abstract : Background: The rate of decline of FEV1 in people with COPD is important as it has been associated with increased dyspnoea, decreased quality of life, and mortality. To date, the majority of lung function decline studies in people with COPD have occurred in sub-specific or randomised control trial populations, which have extensive inclusion and exclusion criteria. Therefore, it is unclear how generalizable results are to a wider population of COPD patients. Method: We used UK Clinical Practice Research Datalink (primary care) linked to Hospital Episode Statistics. We identified patients diagnosed with COPD, aged 35 years or older, who were smokers or ex-smokers, and who had at least 2 FEV1 measurements at least 6 months apart. Follow-up started from first FEV1 after the 1st April 2004 until censoring at death, leaving the database, or the 29th February 2016. Mixed effects linear regression was used to describe the rate of FEV1 decline. Further models investigated the association between baseline smoking status, exacerbation of COPD (AECOPD) frequency in first year of follow-up, baseline airflow obstruction, and baseline MRC dyspnoea score and rate of FEV1 decline. Results: 33, 392 COPD patients with complete data were included and median follow-up time was 6.6 years (IQR 4.4–9.0). Conclusion: Amongst a primary care COPD population, the average FEV1 decline was 13.2 ml/year. Decline was faster in current smokers and COPD patients with milder airflow obstruction. The increase in FEV1 change in patients with less <50% FEV1% predicted was likely to be due to survival bias. Please refer to page A267 for declarations of interest related to this abstract.