Division of General Medicine, Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York.
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York.
Am J Epidemiol. 2018 Nov 1;187(11):2265-2278. doi: 10.1093/aje/kwy139.
Chronic lower respiratory diseases (CLRDs) are the fourth leading cause of death in the United States. To support investigations into CLRD risk determinants and new approaches to primary prevention, we aimed to harmonize and pool respiratory data from US general population-based cohorts. Data were obtained from prospective cohorts that performed prebronchodilator spirometry and were harmonized following 2005 ATS/ERS standards. In cohorts conducting follow-up for noncardiovascular events, CLRD events were defined as hospitalizations/deaths adjudicated as CLRD-related or assigned relevant administrative codes. Coding and variable names were applied uniformly. The pooled sample included 65,251 adults in 9 cohorts followed-up for CLRD-related mortality over 653,380 person-years during 1983-2016. Average baseline age was 52 years; 56% were female; 49% were never-smokers; and racial/ethnic composition was 44% white, 22% black, 28% Hispanic/Latino, and 5% American Indian. Over 96% had complete data on smoking, clinical CLRD diagnoses, and dyspnea. After excluding invalid spirometry examinations (13%), there were 105,696 valid examinations (median, 2 per participant). Of 29,351 participants followed for CLRD hospitalizations, median follow-up was 14 years; only 5% were lost to follow-up at 10 years. The NHLBI Pooled Cohorts Study provides a harmonization standard applied to a large, US population-based sample that may be used to advance epidemiologic research on CLRD.
慢性下呼吸道疾病（CLRDs）是美国第四大死亡原因。为了支持对 CLRD 风险决定因素和初级预防新方法的研究，我们旨在协调和汇总来自美国基于一般人群的队列的呼吸数据。数据来自前瞻性队列，这些队列进行了支气管扩张剂前肺活量测定，并按照 2005 年 ATS/ERS 标准进行了协调。在对非心血管事件进行随访的队列中，CLRD 事件定义为住院/死亡被判定为与 CLRD 相关或分配了相关的管理代码。统一应用了编码和变量名称。该汇总样本包括 9 个队列中的 65251 名成年人，这些队列在 1983 年至 2016 年期间进行了与 CLRD 相关的死亡率随访，随访时间为 653380 人年。平均基线年龄为 52 岁；56%为女性；49%为从不吸烟者；种族/民族构成分别为 44%的白人、22%的黑人、28%的西班牙裔/拉丁裔和 5%的美洲印第安人。超过 96%的人有关于吸烟、临床 CLRD 诊断和呼吸困难的完整数据。在排除无效的肺活量检查（13%）后，有 105696 份有效检查（中位数，每位参与者 2 次）。在 29351 名因 CLRD 住院而接受随访的参与者中，中位随访时间为 14 年；只有 5%的人在 10 年内失访。NHLBI 汇总队列研究提供了一个适用于大型美国人群样本的协调标准，可用于推进 CLRD 的流行病学研究。
