Life Expectancy and Years of Life Lost in a Large Contemporary Cohort of Individuals With COPD

In this issue of JAMA Internal Medicine, Bhatt and colleagues use data from the National Heart, Lung, and Blood Institute (NHLBI) Pooled Cohorts Study to quantify life expectancy and years of life lost (YLL) from chronic obstructive pulmonary disease (COPD). Compared with persons without COPD, the authors report that YLL among persons with COPD were 1.9 years. Increasing severity of COPD markedly increased YLL: for Global Initiative for COPD (GOLD) stages 1 through 4 (higher stage indicates more severe disease), YLL was 0.7 years for stage 1, 2.6 years for stage 2, 5.1 years for stage 3, and 7.1 years for stage 4. Among persons with COPD, there were no differences in YLL between smokers and never-smokers or by sex. Depending on the severity of COPD, YLL were similar to or greater than the YLL lost for hypertension (2.7), diabetes (4.1), obesity (0.5), and smoking (5.5). These results corroborate previous epidemiologic research and clinical experience: COPD carries substantial public health burden and mortality increases with increasing disease severity.