Pulmonary Disease, Howard University Hospital, 2041 Georgia Ave NW, Washington, DC, 20060USA.
Howard University College of Medicine, 520 W St, NW, Washington, DC, 20059, USA.
Respir Med. 2022 Jul;198:106879. doi: 10.1016/j.rmed.2022.106879. Epub 2022 May 16.
Little is known about Fractional concentration of exhaled Nitric Oxide (FeNO) as a predictor of mortality in persons with asthma or chronic obstructive pulmonary disease (COPD).
This study tested the hypotheses that FeNO level ≥ 25 ppb was associated with mortality in a national cohort of persons with asthma or COPD age ≥ 40 years.
In the 2007-2012 National Health and Nutrition Examination Survey (NHANES), FeNO was measured using an electrochemical sensor. Mortality was determined through 2015 using linkage to the National Death Index. Weighted Cox proportional hazards survival analysis was performed taking the complex survey design into account using STATA V.17.
Among the 611 participants with current asthma, 5.16% died during the follow-up period. FeNO ≥ 25 ppb was associated with a hazard ratio (HR) of 0.20, (p = 0.006, 95% CI:0.068-0.618) alone or with little change after controlling for confounding variables. Due to effect modification, the analysis was repeated in persons with and without a history of emergency department (ED) visit for asthma in the previous year. In 522 persons without ED visits, FeNO ≥ 25 ppb was significantly associated with mortality HR 0.094, 95 CI 0.034-0.26, p < 0.001. In 83 persons with ED visits no significant association remained after controlling for all confounders. (Six persons were omitted from this analysis due to missing data on confounders in the extended regression model.) Among 614 with COPD, FeNO ≥ 25 ppb was not associated with mortality.
In persons with current asthma at baseline, FeNO ≥ 25 ppb was associated with reduced hazard of mortality during follow up among those with no history of ED visits in the previous year. No significant association of FeNO with mortality was seen in persons with COPD.
关于呼出气一氧化氮（FeNO）分数在预测哮喘或慢性阻塞性肺疾病（COPD）患者死亡率方面的作用，目前知之甚少。
本研究检验了以下假设，即在一个年龄≥40 岁的哮喘或 COPD 患者的全国队列中，FeNO 水平≥25 ppb 与死亡率相关。
在 2007-2012 年全国健康和营养调查（NHANES）中，使用电化学传感器测量 FeNO。通过 2015 年与国家死亡指数的链接来确定死亡率。采用 STATA V.17 进行加权 Cox 比例风险生存分析，同时考虑到复杂的调查设计。
在 611 名有当前哮喘的参与者中，5.16%在随访期间死亡。FeNO≥25 ppb 与危险比（HR）为 0.20 相关（p=0.006，95%CI：0.068-0.618），单独或在控制混杂变量后变化不大。由于存在效应修饰，因此在过去一年因哮喘到急诊室（ED）就诊的人和没有到 ED 就诊的人中重复了该分析。在 522 名没有 ED 就诊的人中，FeNO≥25 ppb 与死亡率显著相关（HR 0.094，95%CI 0.034-0.26，p<0.001）。在控制了所有混杂因素后，在 83 名到 ED 就诊的人中，没有发现显著关联。（由于在扩展回归模型中混杂因素缺失，有 6 人被排除在这项分析之外。）在 614 名 COPD 患者中，FeNO≥25 ppb 与死亡率无关。
在基线时有当前哮喘的患者中，在过去一年没有 ED 就诊史的人群中，FeNO≥25 ppb 与随访期间的死亡率降低相关。在 COPD 患者中，FeNO 与死亡率之间没有显著关联。
