Collaro Andrew J, Chang Anne B, Marchant Julie M, Chatfield Mark D, Dent Annette, Blake Tamara, Mawn Patsi, Fong Kwun, McElrea Margaret S
Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Level 5a, 501 Stanley St, South Brisbane, QLD, 4101, Australia.
Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, QLD, Australia.
Lung. 2021 Aug;199(4):417-425. doi: 10.1007/s00408-021-00453-7. Epub 2021 Jul 3.
Northern Territory (NT)-based clinical service data suggest substantial lung function impairment amongst First Nations adults as young as 18-40 years. Our objectives were to describe the burden of disease and lung function of adults living in regional-remote Queensland, identify determinants of lung function, and evaluate the impact of a specialist respiratory outreach service on lung function.
Retrospective 8-year cohort study (February 2012-March 2020) of 1113 First Nations Australian adults (and 648 non-First Nations adults) referred to respiratory outreach clinics in regional-remote Queensland.
In the combined cohort, the forced expiratory volume in 1 s (FEV) was clinically abnormal for 54% of First Nations patients (51% of non-First Nations patients), forced vital capacity (FVC) for 46% (36%), FEV/FVC% for 30% (36%), and gas diffusing capacity (D) for 44% (37%). A respiratory diagnosis was assigned by a respiratory physician in 78% of First Nations (76% non-First Nations) patients. Smoking, household smoke exposure, underweight BMI, and respiratory disease were associated with reduced lung function. In the 40% of patients (709/1765) followed up, FEV and FVC significantly improved (mean change: zFEV = 0.15 [95% CI 0.10-0.20]; zFVC = 0.25 [0.20, 0.31]), and FEV/FVC% significantly reduced (mean = - 0.10 [95%CI - 0.07 to - 0.03]), with no significant change in D. Patients with COPD had lower FEV improvement, whilst underweight and obese patients had lower FVC improvement.
Regional-remote First Nations adult Queenslanders have higher lung function than previously reported, with no lung function decline observed at follow-up visit, including for those with respiratory disease.
基于北领地（NT）的临床服务数据表明，年仅18至40岁的原住民成年人存在严重的肺功能损害。我们的目标是描述居住在昆士兰偏远地区的成年人的疾病负担和肺功能，确定肺功能的决定因素，并评估专科呼吸外展服务对肺功能的影响。
对1113名澳大利亚原住民成年人（以及648名非原住民成年人）进行了为期8年的回顾性队列研究（2012年2月至2020年3月），这些人被转诊至昆士兰偏远地区的呼吸外展诊所。
在合并队列中，54%的原住民患者（51%的非原住民患者）一秒用力呼气量（FEV）临床异常，46%（36%）的用力肺活量（FVC）异常，30%（36%）的FEV/FVC%异常，44%（37%）的气体弥散量（D）异常。78%的原住民患者（76%的非原住民患者）由呼吸内科医生做出了呼吸诊断。吸烟、家庭烟雾暴露、体重指数偏低和呼吸系统疾病与肺功能下降有关。在40%接受随访的患者（709/1765）中，FEV和FVC显著改善（平均变化：zFEV = 0.15 [95%CI 0.10 - 0.20]；zFVC = 0.25 [0.20, 0.31]），FEV/FVC%显著降低（平均 = -0.10 [95%CI -0.07至-0.03]），D无显著变化。慢性阻塞性肺疾病（COPD）患者的FEV改善较低，而体重偏低和肥胖患者的FVC改善较低。
昆士兰偏远地区的原住民成年居民肺功能高于先前报道，随访时未观察到肺功能下降，包括患有呼吸系统疾病的患者。
