Quadriceps strength predicts mortality in patients with moderate to severe chronic obstructive pulmonary disease
Open accessAbstract
BACKGROUND: Prognosis in chronic obstructive pulmonary disease (COPD) is poorly predicted by indices of air flow obstruction, because other factors that reflect the systemic nature of the disease also influence prognosis. OBJECTIVE: To test the hypothesis that a reduction in quadriceps maximal voluntary contraction force (QMVC) is a useful predictor of mortality in patients with COPD. METHODS: A mortality questionnaire was sent to the primary care physician of 184 patients with COPD who had undergone quadriceps strength measurement over the past 5 years. QMVC was expressed as a percentage of the patient's body mass index. The end point measured was death or lung transplantation, and median (range) follow-up was 38 (1-54) months. RESULTS: Data were obtained for 162 patients (108 men and 54 women) with a mean (SD) percentage of forced expiratory volume in 1 s (FEV1) predicted of 35.6 (16.2), giving a response rate of 88%. Transplant-free survival of the cohort was 93.5% at 1 year and 87.1% at 2 years. Cox regression models showed that the mortality risk increased with increasing age and with reducing QMVC. Only age (HR 1.72 (95% CI 1.14 to 2.6); p = 0.01) and QMVC (HR 0.91 (95% CI 0.83 to 0.99); p = 0.036) continued to be significant predictors of mortality when controlled for other variables in the multivariate analysis. CONCLUSION: QMVC is simple and provides more powerful prognostic information on COPD than that provided by age, body mass index and forced expiratory volume in 1 s.
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Quadriceps strength predicts mortality in COPD.
“For example, quadriceps strength predicts mortality in COPD.24”
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Cites
Vestbo, J., Hurd, S. S., Agustí, A. G., Jones, P. W., Vogelmeier, C., Anzueto, A., Barnes, P. J., Fabbri, L. M., Martinez, F. J., Nishimura, M., et al. (2013) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201204-0596pp · Cited by 15,983 · see citing works
PAUWELS, R. A., Buist, A. S., CALVERLEY, P. M. A., Jenkins, C. R., & Hurd, S. S. (2001) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.163.5.2101039 · Cited by 6,529 · see citing works
Proportional hazards tests and diagnostics based on weighted residuals
GRAMBSCH, P. M., & THERNEAU, T. M. (1994) · Biometrika · doi:10.1093/biomet/81.3.515 · Cited by 5,885 · see citing works
Celli, B. R., Cote, C. G., Marin, J. M., Casanova, C., Montes de Oca, M., Mendez, R. A., Pinto Plata, V., & Cabral, H. J. (2004) · New England Journal of Medicine · doi:10.1056/nejmoa021322 · Cited by 4,015 · see citing works
Newman, A. B., Kupelian, V., Visser, M., Simonsick, E. M., Goodpaster, B. H., Kritchevsky, S. B., Tylavsky, F. A., Rubin, S. M., Harris, T. B., & on Behalf of the Health, A. A. B. C. S. I. (2006) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/61.1.72 · Cited by 1,692 · see citing works
Weight Loss Is a Reversible Factor in the Prognosis of Chronic Obstructive Pulmonary Disease
Schols, A. M. W. J., Slangen, J. J. M., Volovics, L., & Wouters, E. F. �. (1998) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.157.6.9705017 · Cited by 1,084 · see citing works
Prognostic Value of Nutritional Status in Chronic Obstructive Pulmonary Disease
LANDBO, C., Prescott, E., Lange, P., Vestbo, J., & Almdal, T. (1999) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.160.6.9902115 · Cited by 1,028 · see citing works
Peripheral Muscle Weakness Contributes to Exercise Limitation in COPD
Gosselink, R., Troosters, T., & Decramer, M. (1996) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.153.3.8630582 · Cited by 1,024 · see citing works
Marquis, K., Debigaré, R., Lacasse, Y., Leblanc, P., Jobin, J., Carrier, G., & Maltais, F. (2002) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.2107031 · Cited by 840 · see citing works
Peripheral Muscle Weakness in Patients with Chronic Obstructive Pulmonary Disease
BERNARD, S., LeBLANC, P., WHITTOM, F., CARRIER, G., JOBIN, J., BELLEAU, R., & MALTAIS, F. (1998) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.158.2.9711023 · Cited by 817 · see citing works
Body composition and mortality in chronic obstructive pulmonary disease
Schols, A. M. W. J., Broekhuizen, R., Weling-Scheepers, C. A., & Wouters, E. F. �. (2005) · American Journal of Clinical Nutrition · doi:10.1093/ajcn.82.1.53 · Cited by 808 · see citing works
Risk factors of readmission to hospital for a COPD exacerbation: a prospective study
García‐Aymerich, J. (2003) · Thorax · doi:10.1136/thorax.58.2.100 · Cited by 724 · see citing works
Body composition and mortality in chronic obstructive pulmonary disease
Schols, A. M. W. J., Broekhuizen, R., Weling-Scheepers, C. A., & Wouters, E. F. �. (2005) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/82.1.53 · Cited by 659 · see citing works
Oga, T., Nishimura, K., Tsukino, M., Satô, S., & Hajiro, T. (2003) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200206-583oc · Cited by 586 · see citing works
Hamilton, A., Killian, K. J., Summers, E., & Jones, N. L. (1995) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.152.6.8520771 · Cited by 570 · see citing works
Human Skeletal Muscle Function: Description of Tests and Normal Values
Edwards, R. H. T., Young, A., Hosking, G., & Jones, D. A. (1977) · Clinical Science · doi:10.1042/cs0520283 · Cited by 499 · see citing works
Spruit, M. A. (2003) · Thorax · doi:10.1136/thorax.58.9.752 · Cited by 476 · see citing works
A new measure of prognostic separation in survival data
Royston, P., & Sauerbrei, W. (2004) · Statistics in Medicine · doi:10.1002/sim.1621 · Cited by 450 · cited 3× · see citing works
“Additionally, the discriminative ability of different multiple models was compared using the D measure of Royston and Sauerbrei,23 as well as the D-based version of Kent and O’Quigley’s24 measure of dependence (R2 measure).”
BackgroundMethodPizov, R. (2004) · Survey of Anesthesiology · doi:10.1097/01.sa.0000144225.72154.cf · Cited by 394 · see citing works
Proportional Hazards Tests and Diagnostics Based on Weighted Residuals
Grambsch, P. M., & Therneau, T. M. (1994) · Biometrika · doi:10.2307/2337123 · Cited by 356 · see citing works
Mostert, R., Goris, A. H. C., Weling-Scheepers, C. A., Wouters, E. F. �., & Schols, A. M. W. J. (2000) · Respiratory Medicine · doi:10.1053/rmed.2000.0829 · Cited by 329 · see citing works
Man, W. D., Polkey, M. I., Donaldson, N., Gray, B. J., & Moxham, J. (2004) · BMJ · doi:10.1136/bmj.38258.662720.3a · Cited by 312 · see citing works
Self-citationPrescott, E., Almdal, T., Mikkelsen, K. L., Tofteng, C. L., Vestbo, J., & Lange, P. (2002) · European Respiratory Journal · doi:10.1183/09031936.02.00532002 · Cited by 273 · see citing works
Bedside methodsversusdual energy X‐ray absorptiometry for body composition measurement in COPD
STEINER, M. C., Barton, R. L., Singh, S., & Morgan, M. D. (2002) · European Respiratory Journal · doi:10.1183/09031936.02.00279602 · Cited by 261 · see citing works
Baarends, E. M., Schols, A. M. W. J., Mostert, R., & Wouters, E. F. �. (1997) · European Respiratory Journal · doi:10.1183/09031936.97.10122807 · Cited by 241 · see citing works
Body composition and exercise performance in patients with chronic obstructive pulmonary disease.
Schols, A. M. W. J., Mostert, R., Soeters, P. B., & Wouters, E. F. �. (1991) · Thorax · doi:10.1136/thx.46.10.695 · Cited by 234 · see citing works
Chailleux, E., Laaban, J., & Veale, D. (2003) · Chest · doi:10.1378/chest.123.5.1460 · Cited by 221 · see citing works
Man, W. D. (2003) · Thorax · doi:10.1136/thorax.58.8.665 · Cited by 159 · see citing works
Self-citationMeasures of dependence for censored survival data
Kent, J. T., & O’Quigley, J. (1988) · Biometrika · doi:10.1093/biomet/75.3.525 · Cited by 155 · see citing works
Gea, J., Pastó, M., Carmona, M. A., Orozco‐Levi, M., Palomeque, J., & Broquetas, J. M. (2001) · European Respiratory Journal · doi:10.1183/09031936.01.17509390 · Cited by 147 · see citing works
Magnetic stimulation for the measurement of respiratory and skeletal muscle function
Man, W. D., Moxham, J., & Polkey, M. I. (2004) · European Respiratory Journal · doi:10.1183/09031936.04.00029004 · Cited by 142 · see citing works
Self-citationWeight Loss is a Reversible Factor in the Prognosis of Chronic Obstructive Pulmonary Disease
Schols, A. M. W. J., Slangen, J. J. M., Volovics, L., & Wouters, E. F. �. (1999) · Journal of Cardiopulmonary Rehabilitation · doi:10.1097/00008483-199907000-00014 · Cited by 132 · see citing works
Body composition and mortality in chronic obstructive pulmonary disease
Schols, A. M. W. J., Broekhuizen, R., Scheepers, C. A. W., et al. (2005) · Respiratory Medicine COPD Update · doi:10.1016/j.rmedu.2005.09.028 · Cited by 122 · see citing works
Angiotensin Converting Enzyme Genotype and Strength in Chronic Obstructive Pulmonary Disease
Hopkinson, N. S., Nickol, A. H., Payne, J., Hawe, E., Man, W. D., Moxham, J., Montgomery, H., & Polkey, M. I. (2004) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200304-578oc · Cited by 116 · see citing works
Self-citationSlinde, F., Grönberg, A., Engström, C.-P., Rossander-Hulthén, L., & Larsson, S. (2005) · Respiratory Medicine · doi:10.1016/j.rmed.2004.09.024 · Cited by 115 · see citing works
Mid-Arm Muscle Area Is a Better Predictor of Mortality Than Body Mass Index in COPD
Soler‐Cataluña, J. J., Sánchez, L., Martínez‐García, M. Á., et al. (2005) · CHEST Journal · doi:10.1378/chest.128.4.2108 · Cited by 114 · see citing works
Peripheral Muscle Weakness in Patients with Chronic Obstructive Pulmonary Disease.
Bernard, S., Leblanc, P., WHITTOM, F., Carrier, G., Jobin, J., Belleau, R., & Maltais, F. (1998) · Cardiopulmonary Physical Therapy Journal · doi:10.1097/01823246-199809040-00007 · Cited by 110 · see citing works
Influence of Body Weight on the Severity of Dyspnea in Chronic Obstructive Pulmonary Disease
Sahebjami, H., & Sathianpitayakul, E. (2000) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.161.3.9905023 · Cited by 93 · see citing works
Abdominal muscle and quadriceps strength in chronic obstructive pulmonary disease
Man, W. D. (2005) · Thorax · doi:10.1136/thx.2005.040709 · Cited by 85 · see citing works
Self-citationSlinde, F., Grönberg, A., Engström, C.-P., et al. (2005) · Respiratory Medicine COPD Update · doi:10.1016/j.rmedu.2005.09.030 · Cited by 33 · see citing works
Mid-arm muscle area is a better predictor of mortality than body mass index in COPD
Soler‐Cataluña, J. J., Sanchez-Sanchez, L., Martínez‐García, M. Á., et al. (2006) · Respiratory Medicine COPD Update · doi:10.1016/j.rmedu.2006.01.025 · Cited by 18 · see citing works
Catastrophe Theory Model for Decelerations of Fetal Heart Rate
Kikuchi, A., Unno, N., Horikoshi, T., et al. (2005) · Gynecologic and Obstetric Investigation · doi:10.1159/000088812 · Cited by 5 · see citing works
Measures of Dependence for Censored Survival Data
Kent, J. T., & O’Quigley, J. (1988) · Biometrika · doi:10.2307/2336603 · Cited by 4 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- Steiner MC, Barton RL, Singh SJ, et al. Bedside methods versus dual energy x rayabsorptiometry for body composition measurement in COPD. Eur Respir J 2002;19:626-31.
Cited by
Sorted by citations
Muscle wasting in disease: molecular mechanisms and promising therapies
Cohen, S., Nathan, J. A., & Goldberg, A. L. (2015) · Nature Reviews Drug Discovery · doi:10.1038/nrd4467 · Cited by 1,089 · see citing works
Association between muscular strength and mortality in men: prospective cohort study
Ruiz, J. R., Sui, X., Lobelo, F., Morrow, J. R., Jackson, A. W., Sjostrom, M., & Blair, S. N. (2008) · BMJ · doi:10.1136/bmj.a439 · Cited by 815 · see citing works
British Thoracic Society guideline on pulmonary rehabilitation in adults: accredited by NICE
Bolton, C. E., Bevan-Smith, E. F., Blakey, J. D., Crowe, P., Elkin, S. L., Garrod, R., Greening, N. J., Heslop, K., Hull, J. H., Man, W. D.-C., et al. (2013) · Thorax · doi:10.1136/thoraxjnl-2013-203808 · Cited by 717 · see citing works
Self-citationHerold, F., Törpel, A., Schega, L., & Müller, N. G. (2019) · European Review of Aging and Physical Activity · doi:10.1186/s11556-019-0217-2 · Cited by 349 · see citing works
Quadriceps wasting and physical inactivity in patients with COPD
Shrikrishna, D., Patel, M., Tanner, R. J., Seymour, J. M., Connolly, B. A., Puthucheary, Z. A., Walsh, S. L. F., Bloch, S. A., Sidhu, P. S., Hart, N., et al. (2012) · European Respiratory Journal · doi:10.1183/09031936.00170111 · Cited by 331 · see citing works
Self-citationSkeletal muscle dysfunction in patients with chronic obstructive pulmonary disease
Hussain, S., Cheol, K., & Mofarrahi, M. (2008) · International Journal of Chronic Obstructive Pulmonary Disease · doi:10.2147/copd.s4480 · Cited by 224 · see citing works
Bin, Y., Xiao, Y., Huang, D., Ma, Z., Liang, Y., Bai, J., Zhang, W., Liang, Q., Zhang, J., Zhong, X., et al. (2019) · American Journal of Physiology-Lung Cellular and Molecular Physiology · doi:10.1152/ajplung.00005.2018 · Cited by 35 · see citing works
Quadriceps muscle fat infiltration is associated with cardiometabolic risk in <scp>COPD</scp>
Vivodtzev, I., Moncharmont, L., Tamisier, R., Borel, J., Arbib, F., Wuyam, B., Lévy, P., Maltais, F., Ferretti, G., & Pépin, J. (2018) · Clinical Physiology and Functional Imaging · doi:10.1111/cpf.12481 · Cited by 25 · see citing works
Lewis, A., Dullaghan, D., Townes, H., Green, A., Potts, J., & Quint, J. K. (2019) · Chronic Respiratory Disease · doi:10.1177/1479973119838283 · Cited by 21 · see citing works
“(P3) I didn’t know much about COPD.”
BackgroundInfluentialBalnis, J., Drake, L. A., Vincent, C. E., Korponay, T. C., Singer, D. V., Lacomis, D., Lee, C. G., Elias, J. A., Jourd’heuil, D., Singer, H. A., et al. (2021) · American Journal of Respiratory Cell and Molecular Biology · doi:10.1165/rcmb.2020-0551oc · Cited by 19 · see citing works
- Authors
- Swallow, E. B., Reyes, D., Hopkinson, N. S., Man, W. D.-C., Porcher, R., Cetti, E. J., Moore, A. J., Moxham, J., & Polkey, M. I.
- Affiliations
- Royal Brompton Hospital (GB)
- King's College London (GB)
- Hôpital Saint-Louis (FR)
- Corresponding author
- Swallow, E. B
- Venue
- Thorax
- Publisher
- BMJ
- Published
- 2007-02-01
- Volume
- 62
- Issue
- 2
- Pages
- 115-120
- ISSN
- 0040-6376 (ISSN-L)
- PMC
- PMC2111256
- OpenAlex
- W2062538521
- Cited by
- 728
- References
- 43
- Citations by year
- 2026: 20 · 2025: 21 · 2024: 25 · 2023: 22 · 2022: 42 · 2021: 41 · 2020: 50 · 2019: 40 · 2018: 55 · 2017: 40 · 2016: 54 · 2015: 49 · 2014: 54 · 2013: 33 · 2012: 44
- FWCI
- 20.10
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Thorax (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- King's College London
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- chronic obstructive pulmonary disease, quadriceps strength, mortality prediction, prognosis, muscle strength, age, body mass index, FEV1, lung transplantation, transplant-free survival
- MeSH terms
- Female, Follow-Up Studies, Forced Expiratory Volume, Humans, Male, Middle Aged, Prognosis, Disease-Free Survival, Pulmonary Disease, Chronic Obstructive, Quadriceps Muscle, Muscle Strength
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