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加拿大老龄化纵向研究(CLSA)中 productive 和干性慢性咳嗽对死亡率的影响

Impact of productive and dry chronic cough on mortality in the Canadian Longitudinal Study on Aging (CLSA).

作者信息

Satia Imran, Mayhew Alexandra J, Sohel Nazmul, Kurmi Om, Killian Kieran J, O'Byrne Paul M, Raina Parminder

机构信息

Department of Medicine, McMaster University, Hamilton, Ontario, Canada.

Firestone Institute for Respiratory Health, St Joseph's Healthcare, Hamilton, Ontario, Canada.

出版信息

J Thorac Dis. 2022 Dec;14(12):5087-5096. doi: 10.21037/jtd-22-1306.

Abstract

BACKGROUND

Chronic cough is a common troublesome condition and accounts for a high burden on quality of life. Previous data investigating the mortality associated with chronic cough has been derived in patients with chronic bronchitis. No data exists on chronic dry cough. Therefore, we investigated if chronic dry and productive cough is independently associated with increased mortality.

METHODS

The Canadian Longitudinal Study on Ageing (CLSA) is a prospective, nationally generalizable, stratified random sample of adults aged 45-85 years at baseline recruited between 2011-2015 and followed up three years later. Chronic cough was identified based on a self-reported daily cough in the last 12 months. Deaths were confirmed by the Ministry of Health and/or completion of descendent questionnaire by a family member. Models were investigated for dry and productive chronic cough and was adjusted for age, sex, smoking, body mass index (BMI), and respiratory diseases.

RESULTS

Of the 30,016 participants, 4,783 (15.9%) reported chronic cough at baseline; 2,724 (57%) had a dry cough, and 2,059 (43%) had productive chronic cough. There was a total of 561 deaths between baseline and follow-up-1 (3 years later). There was a 49% higher risk of death in participants with chronic productive cough {adjusted odds ratio (aOR) 1.49 [95% confidence intervals (CI): 1.08-2.07]}, but not dry chronic cough [aOR 0.85 (0.60-1.20)]. The effects of chronic productive cough on mortality were persistent in those with no airflow obstruction [chronic productive cough aOR 1.90 (1.09-3.31)].

CONCLUSIONS

Chronic productive cough is associated with a higher risk of death, while chronic dry cough has no impact on mortality risk of death in middle-aged and older adults. This highlights the importance of careful evaluation of patients with chronic cough.

摘要

背景

慢性咳嗽是一种常见的令人困扰的病症,给生活质量带来沉重负担。既往有关慢性咳嗽相关死亡率的数据来源于慢性支气管炎患者。目前尚无关于慢性干咳的数据。因此,我们研究了慢性干咳和湿性咳嗽是否与死亡率增加独立相关。

方法

加拿大老龄化纵向研究(CLSA)是一项前瞻性、全国性可推广的分层随机抽样研究,于2011年至2015年招募了基线年龄在45 - 85岁的成年人,并在三年后进行随访。慢性咳嗽根据过去12个月内自我报告的每日咳嗽情况确定。死亡情况由卫生部确认和/或由家庭成员完成家属问卷。对干性和湿性慢性咳嗽模型进行研究,并对年龄、性别、吸烟、体重指数(BMI)和呼吸系统疾病进行调整。

结果

在30,016名参与者中,4,783名(15.9%)在基线时报告有慢性咳嗽;2,724名(57%)为干咳,2,059名(43%)为湿性慢性咳嗽。基线至随访1(三年后)期间共有561例死亡。湿性慢性咳嗽参与者的死亡风险高49% {调整优势比(aOR)1.49 [95%置信区间(CI):1.08 - 2.07]},而干性慢性咳嗽则无此情况 [aOR 0.85(0.60 - 1.20)]。在无气流受限的人群中,湿性慢性咳嗽对死亡率的影响持续存在 [湿性慢性咳嗽aOR 1.90(1.09 - 3.31)]。

结论

湿性慢性咳嗽与较高的死亡风险相关,而慢性干咳对中老年成年人的死亡风险无影响。这凸显了对慢性咳嗽患者进行仔细评估的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cde/9840029/6bf4dbe253be/jtd-14-12-5087-f1.jpg

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