Which factors portend a poor prognosis in alpha1-antitrypsin deficiency (AATD)?

Updated: Sep 11, 2020
  • Author: Dora E Izaguirre Anariba, MD, MPH; Chief Editor: John J Oppenheimer, MD  more...
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Answer

Prognosis is dependent on how patients are identified. Patients found as a result of screening often have a prognosis near that of healthy people. Those identified because of their symptoms face a more limited future. Specific features that portend a poor prognosis include the following:

  • More severe degree of airflow obstruction (FEV1 >50%, 5-y mortality rate is 4%; FEV1 35-49%, 5-y mortality rate is 12%; FEV1<35, 5-y mortality rate is 50%)

  • Significant bronchodilator response (>12% and >200 mL)

  • Smoking

  • Male sex


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