Emphysema is a chronic lung disease linked with cigarette smoking; a genetic disorder, Alpha-1 antitrypsin deficiency; and rare autoimmune disorders, including systemic vasculitis. Life expectancy with this type of chronic obstructive pulmonary disease (COPD) depends on many factors.
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Normally the air sacs of the lung look like a bunch of grapes. With emphysema, the air sacs are not able to transfer oxygen into the bloodstream. Over time, the sacs lose their elasticity and look similar to a balloon that has been inflated and deflated too many times.
Stale air becomes trapped in the sacs and, over time, the lungs become bigger, causing a condition called hyperinflation. A common complaint with emphysema is shortness of breath. Emphysema also causes strain on the heart when the lungs cannot provide enough oxygen to keep the blood level at a healthy percentage, which is usually above 90 per cent.
Stages of the Disease
Stages of COPD are generally defined using the GOLD criteria (Global Initiative for Chronic Obstructive Lung Disease). The four stages comprise (Stage 1) mild; (Stage 2) moderate; (Stage 3) severe; and (Stage 4) very severe.
Life expectancy with emphysema differs from case to case, according to the National Jewish Health and Medical Research Center.
Types of Tests
There is limited general information on the life expectancy for COPD patients but some tests provide indicators. The FEV1 test---which measures forced volume exhaled during the first second of a breathing testis a part of the broader Pulmonary Function Test (PFT). With a rating of FEV1 of less than 35 per cent, some estimates list a survival rate of less than 50 per cent over four years. However, these numbers are based on many variables, including a person's age, weight, degree of shortness of breath and the cause of the disease.
FEV1 is part of a BODE index (body mass index, obstruction, dyspnea and exercise capacity) that is used to provide information on life expectancy for survival over one, two and four years.
For example, a person who has lung impairment with an FEV1 of 20 per cent, shortness of breath when getting dressed and the ability to walk only 500 feet in six minutes has a two-year survival rate of 69 per cent. Based on studies, 31 out of 100 similar people will not survive two years.
However, a person with better results who can walk a further distance in the six minutes and exhibits an ability to perform activities with less shortness of breath will have a better survival rate.
To understand an individual's situation and prognosis, there are things you can discuss with your health-care provider about life expectancy with emphysema:
How severe is your COPD based on pulmonary function tests (that is, what is your forced expiratory volume in the FEV1 test?
How short of breath are you at rest and with mild and high levels of activity?
Is your weight within the normal range, or are you too thin?
Is pulmonary rehabilitation an option?
Do you have higher than normal carbon-dioxide levels?
Would oxygen help?
Smoking causes emphysema to progress three times faster than normal. This means the FEV1 drops three times more quickly in smokers than in non-smokers. One of the most important aspects to increasing life expectancy is to quit smoking immediately if you do smoke. Cessation will definitely slow down the rate of progression.
Over time, the heart can become enlarged with emphysema. If indicated, using supplemental oxygen helps the heart work less hard and may prevent or prolong heart enlargement.
People with emphysema should avoid upper respiratory infections such as the flu and pneumonia. Vaccines are recommended.
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