Dyspnoea and mortality in older people in the community: a 10-year follow-up
Dyspnoea and mortality in older people in the community: a 10-year follow-up
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DOI：
10.1093/ageing/afs049
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发表时间：
2012-07-01
期刊：
影响因子：
6.7
通讯作者：
O'Mahony, M. Sinead
中科院分区：
文献类型：
--
作者：
Ahmed, Tanvir;Steward, John A.;O'Mahony, M. Sinead
方法：我们发送了经过修改的医学研究委员会 (MRC) 呼吸困难问卷，以识别从居住在社区的 5,002 名 70 岁及以上受试者的全科医生名单中随机选择的 1,404 名受试者的呼吸困难情况。进一步随机抽取 500 名受试者进行临床评估，包括肺功能测试、心电图和超声心动图。对受试者进行了 10 年的随访，并使用全科医生记录和当地死亡登记处记录了所有死亡情况。结果：呼吸困难的患病率为 32.3%。呼吸困难与早期死亡率和晚期死亡率相关。 2 年时，10.1% 的受试者因呼吸困难而死亡，而非呼吸困难的受试者为 3.4%（P = 0.02）。 10 岁时，63.3% 的呼吸困难患者死亡，而 40.5% 的非呼吸困难患者死亡 (P = 0.0001)。 MRC 呼吸困难程度的增加与 10 例死亡相关。高龄（OR：2.27）、男性（OR：1.95）、呼吸困难（OR：2.53）、左心室功能障碍（OR：5.01）和慢性气道疾病（OR：3.04）均与10年死亡率显着相关。调整年龄、性别和基础疾病后，呼吸困难与 10 年死亡率相关（P = 0.02）。结论：呼吸困难是早期和晚期死亡的预测因素，呼吸困难程度的增加与较高的死亡率相关。调整年龄、性别和基础疾病后，呼吸困难是死亡的独立危险因素。
Methods: we sent modified Medical Research Council (MRC) dyspnoea questionnaire to identify breathlessness in 1,404 randomly selected subjects from general practitioner lists of 5,002 subjects aged 70 years and over living in the community. A further random sample of 500 subjects underwent clinical assessment including pulmonary function tests, electrocardiography and echocardiography. Subjects were followed up for 10 years and all deaths were recorded, using general practitioner records and the local death registry.Results: prevalence of dyspnoea was 32.3%. Breathlessness was associated with early mortality and late mortality. At 2 years 10.1% breathless subjects died compared with 3.4% non-breathless (P = 0.02). At 10 years 63.3% breathless had died compared with 40.5% non-breathless (P = 0.0001). Increasing grade of MRC dyspnoea was associated with 10 mortality. Advancing age (OR: 2.27), male gender (OR: 1.95), breathlessness (OR: 2.53), left ventricular dysfunction (OR: 5.01) and chronic airways disease (OR: 3.04) were all significantly associated with 10-year mortality. After adjustment of age, gender and underlying diseases breathlessness was associated with 10-year mortality (P = 0.02).Conclusion: dyspnoea is a predictor of early and late mortality and increasing grade of dyspnoea is associated with a higher rate of mortality. Dyspnoea is an independent risk factor for mortality after adjustment for age, gender and underlying diseases.