呼吸困难与 COPD 发生率、心脏事件和全因死亡率：从中年到整个生命的 44 年随访。
Breathlessness and incidence of COPD, cardiac events and all-cause mortality: A 44-year follow-up from middle age throughout life.
机构信息
Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Respiratory Medicine and Allergology, Lund, Sweden.
Dept of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
出版信息
PLoS One. 2019 Mar 18;14(3):e0214083. doi: 10.1371/journal.pone.0214083. eCollection 2019.
BACKGROUND
Breathlessness is prevalent in the general population and may be associated with adverse health outcomes. This study aimed to evaluate the association of breathlessness with Chronic Obstructive Pulmonary Disease (COPD) events, cardiac events and all-cause mortality from middle-age throughout life.
METHODS
Breathlessness was measured in 699, 55-year old men residing in Malmö, Sweden using modified Medical Research Council (mMRC). COPD events (hospitalisation, death or diagnosis) cardiac events and all-cause mortality was assessed using The Swedish Causes of Death Register and Hospital Discharge Register. Data was analyzed using Cox- and competing risks (Fine-Gray) regression analysis.
RESULTS
695 (99%) of 699 participants died and four emigrated during follow up. Eighty-seven (12%) had mMRC = 1 and 19 (3%) had mMRC≥2. Breathlessness was associated with COPD events; adjusted Sub-Hazard Ratio 2.1 (95% CI, 1.2-3.6) for mMRC = 1 and 7.5 (2.6-21.7) for mMRC ≥ 2 but not associated with cardiac events when adjusting for competing events and confounding. Breathlessness was associated increased all- cause mortality (Hazard Ratios of 1.4 (1.1-1.7) (mMRC = 1) and 3.4 (2.1-5.6) (mMRC ≥ 2)).
CONCLUSION
Breathlessness is associated with increased risk of COPD events and increase in all-cause mortality from age 55 until death.
背景
呼吸困难在普通人群中很常见，可能与不良健康结果有关。本研究旨在评估呼吸困难与慢性阻塞性肺疾病（COPD）事件、心脏事件以及从中年到生命结束的全因死亡率之间的关系。
方法
在瑞典马尔默，使用改良版医学研究委员会（mMRC）量表对 699 名 55 岁男性进行呼吸困难测量。使用瑞典死因登记处和住院记录登记处评估 COPD 事件（住院、死亡或诊断）、心脏事件和全因死亡率。使用 Cox 和竞争风险（Fine-Gray）回归分析进行数据分析。
结果
699 名参与者中，有 695 人（99%）在随访期间死亡，4 人移民。87 人（12%）的 mMRC=1，19 人（3%）的 mMRC≥2。呼吸困难与 COPD 事件相关；调整竞争事件和混杂因素后，mMRC=1 的调整后的亚危险比为 2.1（95%CI，1.2-3.6），mMRC≥2 的为 7.5（2.6-21.7）。但与心脏事件无关。呼吸困难与全因死亡率增加相关（mMRC=1 的危险比为 1.4（1.1-1.7），mMRC≥2 的为 3.4（2.1-5.6））。
结论
呼吸困难与 COPD 事件风险增加以及 55 岁至死亡期间全因死亡率增加相关。
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