Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University, SE-901 85 Umeå, Sweden.
BMC Pulm Med. 2012 Jan 9;12:1. doi: 10.1186/1471-2466-12-1.
The poor recognition and related underdiagnosis of COPD contributes to an underestimation of mortality in subjects with COPD. Data derived from population studies can advance our understanding of the true burden of COPD. The objective of this report was to evaluate the impact of COPD on mortality and its predictors in a cohort of subjects with and without COPD recruited during the twenty first century.
All subjects with COPD (n = 993) defined according to the GOLD spirometric criteria, FEV1/FVC < 0.70, and gender- and age-matched subjects without airway obstruction, non-COPD (n = 993), were identified in a clinical follow-up survey of the Obstructive Lung Disease in Northern Sweden (OLIN) Studies cohorts in 2002-2004. Mortality was observed until the end of year 2007. Baseline data from examination at recruitment were used in the risk factor analyses; age, smoking status, lung function (FEV1 % predicted) and reported heart disease.
The mortality was significantly higher among subjects with COPD, 10.9%, compared to subjects without COPD, 5.8% (p < 0.001). Mortality was associated with higher age, being a current smoker, male gender, and COPD. Replacing COPD with FEV1 % predicted in the multivariate model resulted in the decreasing level of FEV1 being a significant risk factor for death, while heart disease was not a significant risk factor for death in any of the models.
In this cohort COPD and decreased FEV1 were significant risk factors for death when adjusted for age, gender, smoking habits and reported heart disease.
COPD 的识别和相关诊断不足导致 COPD 患者的死亡率被低估。来自人群研究的数据可以增进我们对 COPD 真实负担的理解。本报告的目的是评估 COPD 对 21 世纪招募的 COPD 和非 COPD 患者队列死亡率及其预测因素的影响。
根据 GOLD 肺量计标准，FEV1/FVC<0.70，以及性别和年龄匹配的无气道阻塞的非 COPD 患者（n=993），在 2002-2004 年对北欧阻塞性肺病（OLIN）研究队列的临床随访调查中确定所有 COPD（n=993）患者。观察死亡率直到 2007 年底。使用招募时检查的基线数据进行危险因素分析；年龄、吸烟状况、肺功能（FEV1%预计值）和报告的心脏病。
COPD 患者的死亡率明显高于非 COPD 患者，分别为 10.9%和 5.8%（p<0.001）。死亡率与年龄较高、当前吸烟、男性和 COPD 相关。在多变量模型中用 FEV1%预计值替代 COPD，结果表明 FEV1 降低是死亡的显著危险因素，而心脏病在任何模型中均不是死亡的显著危险因素。
在本队列中，COPD 和 FEV1 降低是死亡的显著危险因素，可通过年龄、性别、吸烟习惯和报告的心脏病进行调整。
