Lange P, Vestbo J, Nyboe J
Copenhagen City Heart study, Epidemiological Research Unit dept. 7121, Rigshospitalet, Denmark.
Eur Respir J. 1995 Oct;8(10):1694-8. doi: 10.1183/09031936.95.08101694.
The aim of this study was to identify possible risk indicators for pneumonia leading to death and hospitalization in the general population. We followed 6,158 men and 7,265 women aged 30-70 years, who participated in the Copenhagen City Heart Study, a prospective population study, for 12 years with regard to mortality and hospital admissions for pneumonia. A total of 260 deaths with pneumonia as main or contributory death cause had occurred, and 405 subjects had been admitted to hospital at least once because of pneumonia. Mortality and hospitalization were analysed by multivariate Cox regression models. In addition to increasing age, forced expiratory volume in one second (FEV1) was strongly and consistently related to both pneumonia related mortality and hospitalization. Women with FEV1 < 60% predicted had a relative risk of 5.7 (95% confidence interval: 2.9-11) and 3.6 (2.1-6.4) for death and hospitalization, respectively, when compared with women with FEV1 > or = 100% predicted. Similar, although lower, relative risks were observed in men. Other significant risk indicators for hospitalization were: self-reported asthma (women), mucus hypersecretion (women and men), history of stroke (men) and smoking (women). We conclude that, in addition to age, reduced FEV1 is the most important risk indicator for severe pneumonia.
本研究的目的是确定普通人群中导致肺炎死亡和住院的可能风险指标。我们对哥本哈根城市心脏研究（一项前瞻性人群研究）中6158名年龄在30至70岁之间的男性和7265名女性进行了为期12年的随访，观察其肺炎死亡率和住院情况。共有260例以肺炎作为主要或次要死亡原因的死亡病例发生，405名受试者因肺炎至少住院一次。通过多变量Cox回归模型分析死亡率和住院情况。除年龄增加外，一秒用力呼气量（FEV1）与肺炎相关死亡率和住院率均密切且持续相关。预测FEV1<60%的女性与预测FEV1≥100%的女性相比，死亡和住院的相对风险分别为5.7（95%置信区间：2.9-11）和3.6（2.1-6.4）。男性中观察到类似但较低的相对风险。其他导致住院的重要风险指标包括：自我报告的哮喘（女性）、黏液分泌过多（女性和男性）、中风病史（男性）和吸烟（女性）。我们得出结论，除年龄外，FEV1降低是严重肺炎最重要的风险指标。
