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40-79岁成年人中自我报告的慢性阻塞性肺疾病的患病率及相关因素:2007-2012年美国国家健康与营养检查调查(NHANES)

Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

作者信息

Tilert Timothy, Paulose-Ram Ryne, Howard Donna, Butler James, Lee Sunmin, Wang Min Qi

机构信息

Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, 3311 Toledo Road, Hyattsville, MD 20782, USA.

Department of Behavioral and Community Health, University of Maryland School of Public Health, 4200 Valley Drive, College Park, MD 20742, USA.

出版信息

EC Pulmonol Respir Med. 2018;7(9):650-662. Epub 2018 Aug 28.

Abstract

INTRODUCTION

Chronic obstructive pulmonary disease (COPD) is a respiratory disease that often goes undiagnosed, particularly in its early stages.

OBJECTIVE

To examine sociodemographic, general health, and COPD specific factors, including severity of lung obstruction, that are associated with healthcare provider-diagnosed COPD among U.S. adults.

METHODS

NHANES cross-sectional data collected from 2007-2012 on adults aged 40-79 years (n=10,219) were analyzed. The primary outcome was self-reported COPD diagnosis with predictive factors analyzed via chi-square and logistic regression analyses.

RESULTS

During 2007-2012, 5.2% of US adults aged 40-79 reported being diagnosed with COPD. Among those diagnosed, 50.8% reported fair or poor health, 47.1% were currently smoking cigarettes, 49.1% were taking prescription respiratory medication, 36.4% had moderate or worse lung obstruction, and nearly 90% had one or more respiratory symptoms. Logistic regression revealed positive associations between receiving a COPD diagnosis and the following: being white (AOR: 3.08, 95% CI: 1.82-5.20); being aged 60-79 years (AOR: 1.65, 95% CI: 1.07-2.53); reporting fair/poor health (AOR: 2.91, CI: 1.55-5.46); having 4-9 (AOR: 3.5, CI: 1.3-9.4) or 10 or more healthcare visits in prior year (AOR: 5.06, CI: 1.62-15.77); being a former (AOR: 1.75, CI: 1.2-2.5) or current smoker (AOR: 1.70, CI: 1.17-2.48); having more severe lung obstruction (AOR: 4.90, CI: 3.28-7.32); having 3 or more respiratory symptoms (AOR: 22.07, CI: 12.03-40.49).

CONCLUSIONS

Multiple factors are associated with self-reported COPD diagnosis with number of reported respiratory symptoms having the strongest association. After controlling for other factors, having mild lung obstruction was not associated with being diagnosed.

摘要

引言

慢性阻塞性肺疾病(COPD)是一种常未被诊断出来的呼吸系统疾病,尤其是在其早期阶段。

目的

研究社会人口统计学、总体健康状况以及COPD特定因素,包括肺阻塞严重程度,这些因素与美国成年人中医疗服务提供者诊断出的COPD相关。

方法

分析了2007年至2012年收集的40至79岁成年人(n = 10219)的美国国家健康和营养检查调查(NHANES)横断面数据。主要结局是自我报告的COPD诊断,并通过卡方检验和逻辑回归分析对预测因素进行分析。

结果

在2007年至2012年期间,40至79岁的美国成年人中有5.2%报告被诊断出患有COPD。在那些被诊断出的人中,50.8%报告健康状况一般或较差,47.1%目前吸烟,49.1%正在服用处方呼吸药物,36.4%有中度或更严重的肺阻塞,近90%有一个或多个呼吸道症状。逻辑回归显示,COPD诊断与以下因素之间存在正相关:白人(调整后比值比[AOR]:3.08,95%置信区间[CI]:1.82 - 5.20);年龄在60至79岁(AOR:1.65,95% CI:1.07 - 2.53);报告健康状况一般/较差(AOR:2.91,CI:1.55 - 5.46);上一年有4至9次(AOR:3.5,CI:1.3 - 9.4)或10次及以上医疗就诊(AOR:5.06,CI:1.62 - 15.77);曾经吸烟(AOR:1.75,CI:1.2 - 2.5)或目前吸烟(AOR:1.70,CI:1.17 - 2.48);有更严重的肺阻塞(AOR:4.90,CI:3.28 - 7.32);有3个或更多呼吸道症状(AOR:22.07,CI:12.03 - 40.49)。

结论

多种因素与自我报告的COPD诊断相关,报告的呼吸道症状数量相关性最强。在控制其他因素后,轻度肺阻塞与被诊断无关。

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