Prevalence, Characteristics, and Prognosis of Early Chronic Obstructive Pulmonary Disease The Copenhagen General Population Study
Prevalence, Characteristics, and Prognosis of Early Chronic Obstructive Pulmonary Disease The Copenhagen General Population Study
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DOI：
10.1164/rccm.201908-1644oc
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发表时间：
2020-03-15
影响因子：
24.7
通讯作者：
Lange, Peter
中科院分区：
文献类型：
--
作者：
Colak, Yunus;Afzal, Shoaib;Lange, Peter
目的：调查普通人群中早期COPD患者的患病率、特征和预后。方法：我们从丹麦当代人群队列中随机选择了105,630名成年人进行调查。早期COPD定义为50岁以下、有10包或以上烟草消费的人的FEV1/FVC低于正常下限。测量和主要结果：在8064名50岁以下、有10包或以上烟草消费的人中，1175人(15%)患有早期COPD，其中58%是现在吸烟者。早期COPD患者更常有慢性呼吸道症状、严重的肺功能损害、哮喘和支气管炎/肺炎病史。在14.4年的随访中，我们观察到在8,064名年轻人中，有117人因阻塞性肺疾病急性住院，227人因肺炎住院，185人死亡。与非COPD患者相比，早期COPD患者急性阻塞性肺疾病住院、急性肺炎住院和全因死亡的多变量调整危险比分别为6.42(95%可信区间，3.39~12.2)、2.03(1.43~2.88)和1.79(1.28~2.52)。结论：在50岁以下、吸烟10包或以上的人群中，15%符合早期COPD的诊断标准。早期COPD患者往往有慢性呼吸道症状和严重的肺功能损害，并增加了急性呼吸道住院和过早死亡的风险。
Rationale: Identification of younger adults at high risk of developing chronic obstructive pulmonary disease (COPD) could lead to implementation of preventive measures before disease onset and halt progression.Objectives: To investigate the prevalence, characteristics, and prognosis of individuals with early COPD in the general population.Methods: We investigated 105,630 randomly chosen adults from a Danish contemporary population-based cohort. Early COPD was defined as FEV1/FVC less than the lower limit of normal in individuals under 50 years of age with 10 pack-years or greater of tobacco consumption.Measurements and Main Results: Among 8,064 individuals under 50 years of age with 10 pack-years or greater of tobacco consumption, 1,175 (15%) had early COPD, of whom 58% were current smokers. Individuals with early COPD more often had chronic respiratory symptoms, severe lung function impairment, asthma, and a history with bronchitis/pneumonia. During the 14.4-year follow-up, we observed 117 acute hospitalizations with obstructive lung disease, 227 acute hospitalizations with pneumonia, and 185 deaths among the 8,064 younger adults. Compared with individuals without COPD, those with early COPD had multivariable adjusted hazard ratios of 6.42 (95% confidence interval, 3.39-12.2) for acute obstructive lung disease hospitalizations, 2.03 (1.43-2.88) for acute pneumonia hospitalizations, and 1.79 (1.28-2.52) for all-cause mortality.Conclusions: Among individuals under 50 years of age and 10 pack-years or greater of tobacco consumption from the general population, 15% fulfill criteria of early COPD. Individuals with early COPD more often have chronic respiratory symptoms and severe lung function impairment, and an increased risk of acute respiratory hospitalizations and early death.