Area di Geriatria, Università Campus Biomedico, Rome, Italy.
Eur Respir J. 2013 Apr;41(4):800-5. doi: 10.1183/09031936.00008812. Epub 2012 Jul 12.
Expressing forced expiratory volume in 1 s (FEV1) as % predicted relies on the assumption of proportional variability and generalisability of prediction equations that may be unrealistic, especially for elderly people. We evaluated the prognostic implications of alternative ways of expressing FEV1. We enrolled 318 patients with chronic obstructive pulmonary disease (COPD) and 475 controls in the Salute Respiratoria nell'Anziano (SARA) study. The risk for 5-, 10- and 15-year mortality associated with FEV1 was studied by expressing FEV1 % pred, standardised by height cubed (FEV1 · Ht(-3)) and as a multiple of the sex-specific first percentile (FEV1 quotient (FEV1Q)). In the group with COPD, the incidence rate ratio for the worst versus the best quintile of FEV1Q was 4.65 (95% CI 2.33-10.37), compared to 2.98 (1.53-6.27) for FEV1 % pred and 3.95 (2.01-8.45) for FEV1 · Ht(-3). The corresponding incidence rate ratios at 15 years were 4.52 (2.84-7.43), 3.16 (2.02-5.07) and 3.52 (2.25-5.63), respectively. In the control group, even moderate reduction of FEV1Q was associated with long-term mortality, while FEV1 % pred was not associated with the outcome. FEV1Q may be more informative about prognosis in an elderly population compared to FEV1 % pred.
将 1 秒用力呼气量（FEV1）表达为预计值的%依赖于预测方程的比例可变性和通用性的假设，这在老年人中可能不现实。我们评估了表达 FEV1 的替代方法的预后意义。我们招募了慢性阻塞性肺疾病（COPD）患者 318 例和对照 475 例进行 Salute Respiratoria nell'Anziano（SARA）研究。通过表达 FEV1 % pred、按身高立方（FEV1 · Ht(-3)）标准化和作为性别特异性第一百分位数的倍数（FEV1 商（FEV1Q））来研究 FEV1 与 5、10 和 15 年死亡率的相关性。在 COPD 组中，FEV1Q 最差与最佳五分位数的发生率比为 4.65（95%CI 2.33-10.37），而 FEV1 % pred 为 2.98（1.53-6.27），FEV1 · Ht(-3) 为 3.95（2.01-8.45）。相应的 15 年发生率比分别为 4.52（2.84-7.43）、3.16（2.02-5.07）和 3.52（2.25-5.63）。在对照组中，即使 FEV1Q 中度降低也与长期死亡率相关，而 FEV1 % pred 与结果无关。与 FEV1 % pred 相比，FEV1Q 可能更能提供关于老年人群预后的信息。
