Sorino Claudio, Sherrill Duane, Guerra Stefano, Enright Paul, Pedone Claudio, Augugliaro Giuseppe, Scichilone Nicola, Battaglia Salvatore, Antonelli-Incalzi Raffaele, Bellia Vincenzo
Department of Medicine, Pneumology, Physiology and Human Nutrition, University of Palermo, via Trabucco 180, Palermo, Italy.
Clin Physiol Funct Imaging. 2011 Mar;31(2):101-7. doi: 10.1111/j.1475-097X.2010.00984.x. Epub 2010 Oct 24.
The ratio of forced expiratory volume in 1 s and forced expiratory volume in 6 s (FEV1/FEV6) has been proposed as an alternative for FEV1/forced vital capacity (FVC) to diagnose obstructive diseases with less effort during spirometry; however, its prognostic value is unknown. We evaluated whether FEV1/FEV6 is a significant predictor of mortality in elderly subjects and compared its prognostic value with that of FEV1/FVC and FEV1.
One thousand nine hundred and seventy-one subjects, aged >65 years, participated in the population-based SA.R.A. study. During the baseline exam, a multidimensional assessment included spirometry. Vital status was determined during 6 years of follow-up. Association of all-cause, cardio-pulmonary (CP) and non-CP mortality with a low FEV1/FEV6, FEV1/FVC and FEV1 was evaluated.
Among subjects with both survival data and acceptable spirometry including FEV6, all-cause unadjusted mortality rates were 7·00 and 2·46 per 100 person-years in subjects with FEV1/FEV6 less than and greater than or equal to lower limit of normal (LLN), respectively (mortality rate ratio: 2·84, 95%CI: 2·12-3·84). After adjustment for age, gender, FVC, smoke exposure and main comorbidities, the risk of all-cause mortality remained significantly increased in subjects with FEV1/FEV6<LLN [hazard ratio (HR): 1·87, 95%CI: 1·35-2·58] as well as in subjects with FEV1/FVC<LLN (HR: 2·01, 95%CI: 1·51-2·90) and FEV1<LLN (HR: 2·17, 95%CI: 1·32-3·57). Similar results were found for CP mortality, but not for non-CP mortality.
A low FEV1/FEV6 is a significant predictor of mortality in older individuals. Its prognostic value is comparable to that of a low FEV1/FVC and FEV1.
1秒用力呼气容积与6秒用力呼气容积之比（FEV1/FEV6）已被提议作为FEV1/用力肺活量（FVC）的替代指标，以便在肺活量测定过程中更轻松地诊断阻塞性疾病；然而，其预后价值尚不清楚。我们评估了FEV1/FEV6是否是老年受试者死亡率的重要预测指标，并将其预后价值与FEV1/FVC和FEV1的预后价值进行比较。
1971名年龄大于65岁的受试者参与了基于人群的SA.R.A.研究。在基线检查期间，进行了包括肺活量测定在内的多维评估。在6年的随访期间确定了生命状态。评估了全因、心肺（CP）和非CP死亡率与低FEV1/FEV6、FEV1/FVC和FEV1之间的关联。
在具有生存数据且肺活量测定结果（包括FEV6）可接受的受试者中，FEV1/FEV6低于正常下限（LLN）和大于或等于正常下限的受试者的全因未调整死亡率分别为每100人年7.00和2.46（死亡率比：2.84，95%CI：2.12 - 3.84）。在调整年龄、性别、FVC、吸烟暴露和主要合并症后，FEV1/FEV6<LLN的受试者（风险比（HR）：1.87，95%CI：1.35 - 2.58）以及FEV1/FVC<LLN（HR：2.01，95%CI：1.51 - 2.90）和FEV1<LLN（HR：2.17，95%CI：1.32 - 3.57）的受试者全因死亡风险仍显著增加。CP死亡率也有类似结果，但非CP死亡率没有。
低FEV1/FEV6是老年个体死亡率的重要预测指标。其预后价值与低FEV1/FVC和FEV1的预后价值相当。
