Survival of patients with severe α1-antitrypsin deficiency with special reference to non-index cases

Abstract

Background - Previous estimates of the survival times of patients with al-antitrypsin deficiency have been based on selected patients. Methods - The survival times of 397 patients with severe oel-antitrypsin deficiency identified by pulmonary impairment (index cases) or through family studies (non-index cases) were compared. Results - The overall median survival time was 54-5 years with no significant difference between men and women. Survival for index cases was less than for the non-index cases regardless of smoking history (49-4 years and 69-3 years respectively). When index and non-index cases were analysed separately there was no difference between the survival of smokers and never smokers in the index group. In the non-index group smokers had a shorter survival time than never smokers. The survival time of never smokers was similar to that of the normal Danish population. Conclusions - The prognosis of severe a;-antitrypsin deficiency is better than previously assumed and, although smoking is a major risk factor, the development of emphysema in patients with severe α1-antitrypsin deficiency is multifactorial.