[Mortality due to chronic obstructive bronchopneumopathies].

Abstract

Many recent studies have drawn attention to the rise in chronic obstructive pulmonary disease (COPD) mortality. COPD is the fifth leading cause of death in developed countries. While the data in these studies do indeed suggest that there is a global rise in COPD mortality, the increase is chiefly confined to old COPD cohorts while mortality is falling in younger COPD cohorts. The trend is probably due to the beneficial effect of stabilization or decrease of the smoking habit in developed countries. Medical antismoking campaigns are starting to be successful. There are many factors predictive of survival in COPD. As a therapeutic approach, long-term oxygen therapy is the only treatment which has definitely been shown (by two well controlled studies) to radically improve survival in hypoxemic COPD patients. However, much indirect evidence suggests that bronchodilators or topical corticosteroids may favourably influence survival in these patients. Well controlled long-term studies on these treatments are urgently needed. In the meantime, COPD patients should benefit from these treatments and smoking should be actively discouraged, to alleviate the heavy burden of COPD morbidity and mortality.