Combined effect of lung function level and decline increases morbidity and mortality risks

Penelope  Baughman; Jacob Louis Marott; Peter Lange; Christopher J Martin; Anoop  Shankar; Edward L Petsonk; Eva  Hnizdo

doi:10.1007/s10654-012-9750-2

Combined effect of lung function level and decline increases morbidity and mortality risks

Penelope Baughman, Jacob Louis Marott, Peter Lange, Christopher J Martin, Anoop Shankar, Edward L Petsonk, Eva Hnizdo

Section of Social Medicine

34 Citations (Scopus)

Abstract

Lung function level and decline are each predictive of morbidity and mortality. Evaluation of the combined effect of these measurements may help further identify high-risk groups. Using Copenhagen City Heart Study longitudinal spirometry data (n = 10,457), 16-21 year risks of chronic obstructive pulmonary disease (COPD) morbidity, COPD or coronary heart disease mortality, and all-cause mortality were estimated from combined effects of level and decline in forced expiratory volume in one second (FEV₁). Risks were evaluated using Cox proportional hazards models for individuals grouped by combinations of baseline predicted FEV₁ and quartiles of slope. Hazard ratios (HR) and 95 % confidence intervals (CI) were estimated using stratified analysis by gender, smoking status, and baseline age (≤45 and >45). For COPD morbidity, quartiles of increasing FEV₁ decline increased HRs (95 % CI) for individuals with FEV₁ at or above the lower limit of normal (LLN) but below 100 % predicted, reaching 5.11 (2.58-10.13) for males, 11.63 (4.75-28.46) for females, and 3.09 (0.88-10.86) for never smokers in the quartile of steepest decline. Significant increasing trends were also observed for mortality and in individuals with a baseline age ≤45. Groups with 'normal' lung function (FEV₁ at or above the LLN) but excessive declines (fourth quartile of FEV₁ slope) had significantly increased mortality risks, including never smokers and individuals with a baseline age ≤45.

Original language	English
Journal	European Journal of Epidemiology
Volume	27
Pages (from-to)	933–943
ISSN	0393-2990
DOIs	https://doi.org/10.1007/s10654-012-9750-2
Publication status	Published - Dec 2012

Access to Document

10.1007/s10654-012-9750-2

Cite this

@article{4e5fe25727cc4e64b881641d2a424488,

title = "Combined effect of lung function level and decline increases morbidity and mortality risks",

abstract = "Lung function level and decline are each predictive of morbidity and mortality. Evaluation of the combined effect of these measurements may help further identify high-risk groups. Using Copenhagen City Heart Study longitudinal spirometry data (n = 10,457), 16-21 year risks of chronic obstructive pulmonary disease (COPD) morbidity, COPD or coronary heart disease mortality, and all-cause mortality were estimated from combined effects of level and decline in forced expiratory volume in one second (FEV1). Risks were evaluated using Cox proportional hazards models for individuals grouped by combinations of baseline predicted FEV1 and quartiles of slope. Hazard ratios (HR) and 95 % confidence intervals (CI) were estimated using stratified analysis by gender, smoking status, and baseline age (≤45 and >45). For COPD morbidity, quartiles of increasing FEV1 decline increased HRs (95 % CI) for individuals with FEV1 at or above the lower limit of normal (LLN) but below 100 % predicted, reaching 5.11 (2.58-10.13) for males, 11.63 (4.75-28.46) for females, and 3.09 (0.88-10.86) for never smokers in the quartile of steepest decline. Significant increasing trends were also observed for mortality and in individuals with a baseline age ≤45. Groups with 'normal' lung function (FEV1 at or above the LLN) but excessive declines (fourth quartile of FEV1 slope) had significantly increased mortality risks, including never smokers and individuals with a baseline age ≤45.",

author = "Penelope Baughman and Marott, {Jacob Louis} and Peter Lange and Martin, {Christopher J} and Anoop Shankar and Petsonk, {Edward L} and Eva Hnizdo",

year = "2012",

month = dec,

doi = "10.1007/s10654-012-9750-2",

language = "English",

volume = "27",

pages = "933–943",

journal = "European Journal of Epidemiology",

issn = "0393-2990",

publisher = "Springer",

}

TY - JOUR

T1 - Combined effect of lung function level and decline increases morbidity and mortality risks

AU - Baughman, Penelope

AU - Marott, Jacob Louis

AU - Lange, Peter

AU - Martin, Christopher J

AU - Shankar, Anoop

AU - Petsonk, Edward L

AU - Hnizdo, Eva

PY - 2012/12

Y1 - 2012/12

N2 - Lung function level and decline are each predictive of morbidity and mortality. Evaluation of the combined effect of these measurements may help further identify high-risk groups. Using Copenhagen City Heart Study longitudinal spirometry data (n = 10,457), 16-21 year risks of chronic obstructive pulmonary disease (COPD) morbidity, COPD or coronary heart disease mortality, and all-cause mortality were estimated from combined effects of level and decline in forced expiratory volume in one second (FEV1). Risks were evaluated using Cox proportional hazards models for individuals grouped by combinations of baseline predicted FEV1 and quartiles of slope. Hazard ratios (HR) and 95 % confidence intervals (CI) were estimated using stratified analysis by gender, smoking status, and baseline age (≤45 and >45). For COPD morbidity, quartiles of increasing FEV1 decline increased HRs (95 % CI) for individuals with FEV1 at or above the lower limit of normal (LLN) but below 100 % predicted, reaching 5.11 (2.58-10.13) for males, 11.63 (4.75-28.46) for females, and 3.09 (0.88-10.86) for never smokers in the quartile of steepest decline. Significant increasing trends were also observed for mortality and in individuals with a baseline age ≤45. Groups with 'normal' lung function (FEV1 at or above the LLN) but excessive declines (fourth quartile of FEV1 slope) had significantly increased mortality risks, including never smokers and individuals with a baseline age ≤45.

AB - Lung function level and decline are each predictive of morbidity and mortality. Evaluation of the combined effect of these measurements may help further identify high-risk groups. Using Copenhagen City Heart Study longitudinal spirometry data (n = 10,457), 16-21 year risks of chronic obstructive pulmonary disease (COPD) morbidity, COPD or coronary heart disease mortality, and all-cause mortality were estimated from combined effects of level and decline in forced expiratory volume in one second (FEV1). Risks were evaluated using Cox proportional hazards models for individuals grouped by combinations of baseline predicted FEV1 and quartiles of slope. Hazard ratios (HR) and 95 % confidence intervals (CI) were estimated using stratified analysis by gender, smoking status, and baseline age (≤45 and >45). For COPD morbidity, quartiles of increasing FEV1 decline increased HRs (95 % CI) for individuals with FEV1 at or above the lower limit of normal (LLN) but below 100 % predicted, reaching 5.11 (2.58-10.13) for males, 11.63 (4.75-28.46) for females, and 3.09 (0.88-10.86) for never smokers in the quartile of steepest decline. Significant increasing trends were also observed for mortality and in individuals with a baseline age ≤45. Groups with 'normal' lung function (FEV1 at or above the LLN) but excessive declines (fourth quartile of FEV1 slope) had significantly increased mortality risks, including never smokers and individuals with a baseline age ≤45.

U2 - 10.1007/s10654-012-9750-2

DO - 10.1007/s10654-012-9750-2

M3 - Journal article

C2 - 23238697

SN - 0393-2990

VL - 27

SP - 933

EP - 943

JO - European Journal of Epidemiology

JF - European Journal of Epidemiology

ER -

Combined effect of lung function level and decline increases morbidity and mortality risks

Abstract

Access to Document

Fingerprint

Cite this