Clinical and Prognostic Impact of low DLco values in patients with GOLD I COPD

ABSTRACT Background The Global Initiative for Obstructive Lung Disease does not promote DLco values in the evaluation of chronic obstructive pulmonary disease (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, gender, pack-years history, BMI, dyspnea, lung function measurements, exercise capacity, BODE index, and history of exacerbations were recorded. A cut off 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 cut off value for all-cause mortality. Results A DLco cut off value of Interpretation In GOLD I COPD patients, a DLco