Pre- and post-bronchodilator lung function as predictors of mortality in the Lung Health Study.
Pre- and post-bronchodilator lung function as predictors of mortality in the Lung Health Study.
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DOI：
10.1186/1465-9921-12-136
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发表时间：
2011-10-12
影响因子：
5.8
通讯作者：
Buist S
中科院分区：
文献类型：
--
作者：
Mannino DM;Diaz-Guzman E;Buist S
慢性阻塞性肺疾病（COPD）应根据支气管扩张剂后肺功能进行分类。然而，大多数COPD纵向研究没有使用支气管扩张剂后的肺功能。我们使用肺健康研究中使用支气管扩张剂前后的肺功能数据来确定这些指标在预测死亡率的能力上是否存在差异。我们的分析仅限于黑人或白色人种的受试者，这些受试者我们有完整的数据，并且参加了1年或5年随访访视。我们根据COPD分类标准，使用支气管扩张剂前后的肺功能，根据受试者的基线肺功能对受试者进行分类。我们进行了生存分析和logistic回归预测死亡，并控制了年龄、性别、种族、治疗组、吸烟状况和肺功能指标（支气管扩张剂治疗前或治疗后）。我们计算了风险比（HR）和95%置信区间（CI），并计算了logistic回归模型的曲线下面积。到研究的第15年，最初的5,887名研究对象中有721人死亡。在第1年样本生存模型中，在使用支气管扩张剂前（HR 0.87，95% CI 0.81，每增加10%为0.94）和使用支气管扩张剂后（HR 0.84，95% CI 0.77，0.90）模型中，较高的FEV1%预测较低的死亡率。相应模型的曲线下面积分别为69.2%和69.4%。同样，使用类别，与肺功能“正常”的人相比，3期或4期疾病受试者在支气管扩张剂治疗前（HR 1.51，95% CI 0.75，3.03）和治疗后（HR 1.45，95% CI 0.41，5.15）模型中的死亡率相似。在第5年样本中，当较大比例的受试者患有3期或4期疾病（支气管扩张剂前组为6.4%）时，支气管扩张剂前（HR 2.68，95% CI 1.51，4.75）和支气管扩张剂后（HR 2.46，95% CI 1.63，3.73）模型的死亡率均显著增加。使用支气管扩张剂前后的肺功能预测死亡率的准确度相似。在预测长期结局的人群研究中，可能不需要使用支气管扩张剂后的肺功能。
Chronic obstructive pulmonary disease (COPD) is supposed to be classified on the basis of post-bronchodilator lung function. Most longitudinal studies of COPD, though, do not have post-bronchodilator lung function available. We used pre-and post bronchodilator lung function data from the Lung Health Study to determine whether these measures differ in their ability to predict mortality. We limited our analysis to subjects who were of black or white race, on whom we had complete data, and who participated at either the 1 year or the 5 year follow-up visit. We classified subjects based on their baseline lung function, according to COPD Classification criteria using both pre- and post-bronchodilator lung function. We conducted a survival analysis and logistic regression predicting death and controlling for age, sex, race, treatment group, smoking status, and measures of lung function (either pre- or post-bronchodilator. We calculated hazard ratios (HR) with 95% confidence intervals (CI) and also calculated area under the curve for the logistic regression models. By year 15 of the study, 721 of the original 5,887 study subjects had died. In the year 1 sample survival models, a higher FEV1 % predicted lower mortality in both the pre-bronchodilator (HR 0.87, 95% CI 0.81, 0.94 per 10% increase) and post-bronchodilator (HR 0.84, 95% CI 0.77, 0.90) models. The area under the curve for the respective models was 69.2% and 69.4%. Similarly, using categories, when compared to people with "normal" lung function, subjects with Stage 3 or 4 disease had similar mortality in both the pre- (HR 1.51, 95% CI 0.75, 3.03) and post-bronchodilator (HR 1.45, 95% CI 0.41, 5.15) models. In the year 5 sample, when a larger proportion of subjects had Stage 3 or 4 disease (6.4% in the pre-bronchodilator group), mortality was significantly increased in both the pre- (HR 2.68, 95% CI 1.51, 4.75) and post-bronchodilator (HR 2.46, 95% CI 1.63, 3.73) models. Both pre- and post-bronchodilator lung function predicted mortality in this analysis with a similar degree of accuracy. Post-bronchodilator lung function may not be needed in population studies that predict long-term outcomes.
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影响因子：
5.8
作者：
Agusti A;Calverley PM;Celli B;Coxson HO;Edwards LD;Lomas DA;MacNee W;Miller BE;Rennard S;Silverman EK;Tal-Singer R;Wouters E;Yates JC;Vestbo J;Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) investigators
通讯作者：
Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) investigators
影响因子：
24.3
作者：
Tashkin, D. P.;Celli, B.;Kesten, S.
通讯作者：
Kesten, S.
影响因子：
2.2
作者：
Perez-Padilla, Rogelio;Hallal, Pedro Curi;Menezes, Ana Maria B
通讯作者：
Menezes, Ana Maria B
影响因子：
39.2
作者：
Anthonisen, NR;Skeans, MA;Connett, JE
通讯作者：
Connett, JE
DOI：
10.1164/ajrccm.159.4.9807121
发表时间：
1999-04-01
影响因子：
24.7
作者：
Hansen, EF;Phanareth, K;Dirksen, A
通讯作者：
Dirksen, A