Patterns of lung function decline in adults predict morbidity and mortality.
Baughman-P; Marott-JL; Lange-P; Hnizdo-E
Am J Epidemiol 2011 Jun; 173(Suppl 11):S143
Background: Increased lung function decline is associated with increased risk of chronic obstructive pulmonary disease (COPD) morbidity and mortality and all-cause mortality, but these associations are not fully explored in long-term patterns of lung function decline or in younger individuals. Methods: Risks of morbidity and mortality were estimated for temporal patterns of decline in forced expiratory volume in one second (FEV1) and for age at lung function decline in the Copenhagen City Heart Study, 1976-2003. Using Cox regression, risks associated with temporal patterns of decline were studied by estimating the rate of decline over two time periods to identify patterns of early, late, or persistent excessive decline in individuals present throughout the study. Cox models were stratified by baseline age (less than or equal to 45 and > 45 years) to examine the effect of age on risk associated with excessive decline. Models were adjusted for baseline age, height-adjusted baseline level of lung function (FEV1/Height3), height, asthma, and respiratory symptoms. Hazard ratios and 95% confidence intervals (CI) estimated risk by gender and for never smokers. Results: For COPD morbidity, hazard ratios (CI) for persistent excessive decline were 6.48 (2.70-15.54) for males and 3.56 (1.71-7.40) for females. In an overall analysis, for individuals 45 years of age or younger, hazard ratios (CI) were 2.09 (1.18-3.70) for males and 5.76 (3.41-9.74) for females. Conclusions: A persistent pattern of lung function decline and increased lung function decline in individuals 45 years or younger were significant predictors for increased future respiratory morbidity and mortality.
Age-groups; Lung-disorders; Lung-function; Morbidity-rates; Mortality-rates; Mortality-surveys; Pulmonary-disorders; Pulmonary-function; Pulmonary-function-tests; Pulmonary-system-disorders; Respiratory-function-tests; Respiratory-system-disorders; Statistical-analysis; Surveillance
Dr. Jane A. Hoppin, National Institute of Environmental Health Sciences, Epidemiology Branch, MD A3-05, P.O. Box 12233, Research Triangle Park, NC 27709-2233
American Journal of Epidemiology