Predictors for mortality from respiratory failure in a general population.
Predictors for mortality from respiratory failure in a general population.
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DOI：
10.1038/srep26053
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发表时间：
2016-05-16
影响因子：
4.6
通讯作者：
Kubota I
中科院分区：
文献类型：
--
作者：
Kobayashi M;Shibata Y;Inoue S;Igarashi A;Sato K;Sato M;Nemoto T;Abe Y;Nunomiya K;Nishiwaki M;Tokairin Y;Kimura T;Daimon M;Makino N;Watanabe T;Konta T;Ueno Y;Kato T;Kayama T;Kubota I
一般人群中呼吸衰竭死亡的风险因素尚未确定。本研究的目的是确定日本一般人群中死于呼吸衰竭的个体的特征。2004年至2006年，共有3253名40岁或以上的成年人参加了日本山形县高市的年度健康检查。审查了截至2010年底的受试者死亡情况; 27例受试者死于呼吸衰竭（肺炎，n = 22; COPD，n = 1;肺纤维化，n = 3;支气管哮喘，n = 1）。考克斯比例风险分析显示，男性、年龄较大、D-二聚体和纤维蛋白原水平较高、体重指数（BMI）和总胆固醇较低、卒中和胃溃疡病史是呼吸道死亡的独立危险因素。在C统计分析、净重新分类改进和综合区分改进中，增加病史和实验室数据显著改善了使用年龄和BMI的呼吸性死亡模型预测。总之，我们在日本一般人群的前瞻性队列中确定了呼吸衰竭死亡率的危险因素。年龄较大、体重过轻、低胆固醇血症、高凝纤溶和有中风或胃溃疡病史的男性因呼吸衰竭死亡的风险较高。
Risk factors for death from respiratory failure in the general population are not established. The aim of this study was to determine the characteristics of individuals who die of respiratory failure in a Japanese general population. In total, 3253 adults aged 40 years or older participated in annual health check in Takahata, Yamagata, Japan from 2004 to 2006. Subject deaths through the end of 2010 were reviewed; 27 subjects died of respiratory failure (pneumonia, n = 22; COPD, n = 1; pulmonary fibrosis, n = 3; and bronchial asthma, n = 1). Cox proportional hazard analysis revealed that male sex; higher age, high levels of D-dimer and fibrinogen; lower body mass index (BMI) and total cholesterol; and history of stroke and gastric ulcer were independent risk factors for respiratory death. On analysis with C-statistics, net reclassification improvement, and integrated discrimination improvement, addition of the disease history and laboratory data significantly improved the model prediction for respiratory death using age and BMI. In conclusion, we identified risk factors for mortality from respiratory failure in a prospective cohort of a Japanese general population. Men who were older, underweight, hypocholesterolemic, hypercoagulo-fibrinolytic, and had a history of stroke or gastric ulcer had a higher risk of mortality due to respiratory failure.