Lung function predicts mortality: 10-year follow-up after lung cancer screening among asbestos-exposed workers
Lung function predicts mortality: 10-year follow-up after lung cancer screening among asbestos-exposed workers
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DOI：
10.1007/s00420-012-0803-3
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发表时间：
2013-08-01
影响因子：
3
通讯作者：
Piirila, Paivi
中科院分区：
文献类型：
--
作者：
Vehmas, Tapio;Pallasaho, Paula;Piirila, Paivi
为探讨肺功能损害对石棉接触工人死亡率的预测价值，对590名石棉接触工人进行肺功能测定和肺弥散量测定。平均随访时间为10.5年。分析了不同肺功能参数与全因死亡率、心血管（I 00-I99）和非恶性呼吸系统疾病（J 00-J 99）死亡率的关系。采用因子分析法建立阻碍因素和限制因素，共发现191例死亡病例。当单独研究时，大多数测量的肺功能变量与死亡率增加相关。一秒用力呼气流量下降（风险比/测量单位= 0.977，95%CI 0.969-0.988，p < 0.001）和弥散功能受损（0.973，0.965-0.981，p < 0.001）与所有原因以及心血管和非恶性呼吸系统疾病的死亡率独立相关。阻塞性因素单独和阻塞性和限制性因素的总和与所有研究的死亡率类别相关。仅限制性因素与全因死亡率和呼吸道死亡率相关，肺功能恶化预示死亡。肺功能受损的原因应进行医学调查，以便采取旨在预防过早死亡的恢复措施。
To assess the predictive value of lung function impairment on mortality among asbestos-exposed workers.A total of 590 workers originally screened for occupational lung disease including spirometry and pulmonary diffusing capacity measurements were followed up for mortality data (ICD-10 classification). The mean follow-up time was 10.5 years. Associations of different lung function parameters with mortality from all causes and from cardiovascular (I00-I99) and non-malignant respiratory diseases (J00-J99) were analysed. Factor analysis was used to create obstructive and restrictive factors.A total of 191 deaths were found altogether. Most measured lung function variables were associated with increased mortality when studied separately. Both decreased forced expiratory flow in one second (hazard ratio/measurement unit = 0.977, 95 % CI 0.969-0.988, p < 0.001) and impaired diffusing capacity (0.973, 0.965-0.981, p < 0.001) were independently associated with mortality from all causes, as well as from cardiovascular and non-malignant respiratory diseases. Both obstructive factor alone and the sum of obstructive and restrictive factors were associated with all studied mortality categories. The restrictive factor alone was associated with all-cause and respiratory mortality.Deteriorated lung function predicts deaths. The reasons for impaired lung function should be medically explored to enable restoring measures aiming thus to prevent premature deaths.