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Open Access Green möglich sobald Postprint bei der ZB eingereicht worden ist.
Long-term outcomes in mild/moderate chronic obstructive pulmonary disease in the European community respiratory health survey.
Am. J. Respir. Crit. Care Med. 180, 956-963 (2009)
Rationale: Little is known about the long-term outcomes of individuals with mild/moderate chronic obstructive pulmonary disease (COPD) according to spirometric criteria. Objectives: To test whether nonsmokers and asymptomatic subjects with a spirometric diagnosis of COPD have a steeper decrease in lung function and higher hospitalization rates than subjects without airway obstruction. Methods: A total of 5,205 subjects without asthma (20-44 years of age) from the general population, with FEV1 >= 50% predicted at baseline, were followed for 9 years in the frame of an international cohort study. Percent decrease in FEV1 (Delta FEV1%) and the annual hospitalization rate for respiratory causes during the follow-up were assessed for each subject. Measurements and Main Results: At baseline, 324 (6.2%) subjects had the prebronchodilator FEV1/FVC ratio less than the lower limit of normal (LLN-COPD), and 105 (2.0%) subjects had the same ratio less than 0.70 (modified GOLD-COPD). At follow-up, smokers with LLN-COPD (n = 205) had a greater mean Delta FEV1% (1.7%; 95% confidence interval [CI], 0.8-2.7) and a higher hospitalization rate (rate ratio [RR], 2.52,95% Cl, 1.65-3.86) than normal subjects. Similarly, symptomatic subjects with LLN-COPD (n = 104) had Delta FEV1% (2.0%; 95% CI, 0.8-3.3) and the hospitalization rate (RR, 4.18; 95% CI, 2.43-7.21) higher than the reference group. By contrast, nonsmokers and asymptomatic subjects with LLN-COPD had outcomes that were similar or even better than normal subjects. Among subjects with LLN-COPD, the association of symptoms with Delta FEV1% varied according to smoking habits (P = 0.007); it was particularly strong in symptomatic smokers and disappeared in symptomatic nonsmokers. Similar results were found with the modified GOLD classification. Conclusions: In relatively young populations, COPD is associated with poor long-term outcomes in smokers and in symptomatic subjects only.
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Publikationstyp
Artikel: Journalartikel
Dokumenttyp
Wissenschaftlicher Artikel
Schlagwörter
Copd; Cohort studies; Spirometry; Hospitalization; Smoking; Air-flow obstruction; Lung-function; Young-adults; Risk-factors; Gold stages; Copd; Prevalence; Cohort; Exacerbations; Definition
ISSN (print) / ISBN
1073-449X
e-ISSN
1535-4970
Quellenangaben
Band: 180,
Heft: 10,
Seiten: 956-963
Verlag
American Thoracic Society
Verlagsort
New York
Nichtpatentliteratur
Publikationen
Begutachtungsstatus
Peer reviewed
Institut(e)
Institute of Epidemiology (EPI)
Institute of Lung Health and Immunity (LHI)
Institute of Lung Health and Immunity (LHI)