PEAK EXPIRATORY FLOW-RATE AND 5-YEAR MORTALITY IN AN ELDERLY POPULATION
PEAK EXPIRATORY FLOW-RATE AND 5-YEAR MORTALITY IN AN ELDERLY POPULATION
复制标题
DOI：
10.1093/oxfordjournals.aje.a115957
复制
发表时间：
1991-04-15
影响因子：
5
通讯作者：
HENNEKENS, CH
中科院分区：
文献类型：
--
作者：
COOK, NR;EVANS, DA;HENNEKENS, CH
1982-1983 年，在马萨诸塞州东波士顿对所有社区居住的 65 岁及以上老年人进行了一项人口调查，使用迷你莱特峰值流量计对 3,582 名参与者（其中符合条件的人的 80%）进行了峰值呼气流量测量。 平均峰值流量为315升/分钟，并计算了根据年龄、性别、身高和体重调整的峰值流量的测量值。 这是 5 年总死亡率的高度显着的（p < 0.0001）预测因子，其确定几乎已经完成。 使用包括年龄、性别和吸烟等术语的比例风险模型，峰值流量每减少 100 升/分钟，相对风险为 1.27（95% 置信区间 1.19-1.36）。 该措施对不同类别吸烟者的影响没有明显改变，非吸烟者的相对风险为 1.24，戒烟者为 1.29，当前吸烟者为 1.26。 在对其他协变量（包括咳嗽、痰和喘息等呼吸道症状）进行调整后，这一发现也仍然存在。心血管危险因素，如心肌梗塞和中风病史；以及收缩压和舒张压；社会经济地位；认知功能简单测试的分数；身体活动和功能能力的测量；以及自我评估的健康状况。 在包含所有这些变量的逐步模型中，峰值流量每减少 100 升/分钟，相对风险为 1.16 (p < 0.0001)，表明峰值流量是老年人总死亡率的强有力的独立预测因子。
During a population survey in 1982-1983 among all community-dwelling elderly aged 65 years and over in East Boston, Massachusetts, measurements of peak expiratory flow rate using the mini-Wright peak flow meter were made on 3,582 participants (80% of those eligible). The average peak flow rate was 315 liters/minute, and a measure of peak flow rate adjusted for age, sex, height, and weight was computed. This was a highly significant (p < 0.0001) predictor of 5-year total mortality, whose ascertainment was virtually complete. The relative risk was 1.27 (95 percent confidence interval 1.19-1.36) per 100 liters/minute decrease in peak flow rate, using a proportional hazards model including terms for age, sex, and smoking. There was no apparent modification of the effect of this measure in various categories of smoking, with relative risks of 1.24 for nonsmokers, 1.29 for ex-smokers, and 1.26 for current smokers. This finding also persisted after adjustments for other covariates, including respiratory symptoms such as cough, phlegm, and wheeze; cardiovascular risk factors such as history of myocardial infarction and stroke; and systolic and diastolic blood pressures; socioeconomic status; scores on simple tests of cognitive function; measures of physical activity and functional ability; and self-assessed state of health. In a stepwise model including all of these variables, the relative risk was 1.16 (p < 0.0001) per 100 liters/minute decrease in peak flow rate, indicating that peak flow rate is a strong independent predictor of total mortality in the elderly.