Mortality in GOLD stages of COPD and its dependence on symptoms of chronic bronchitis

Respiratory Research

Claes-Göran Löfdahl¹  Peter M Nilsson²  Jan-Åke Nilsson²  Kerstin Pehrsson¹  Marie Ekberg-Aronsson¹ 

[1] Department of Respiratory Medicine and Allergology, University of Lund, S-221 85 Lund, Sweden;Department of Medicine, University of Lund, University hospital, S-205 02 Malmö, Sweden

关键词: smoking;    respiratory symptoms;    mortality;    GOLD;    FEV₁;    epidemiology;    COPD;    chronic bronchitis;   

Others  :  1226247
DOI  :  10.1186/1465-9921-6-98

 received in 2005-04-25, accepted in 2005-08-25,  发布年份 2005

【 摘 要 】

Background

The GOLD classification of COPD severity introduces a stage 0 (at risk) comprising individuals with productive cough and normal lung function. The aims of this study were to investigate total mortality risks in GOLD stages 0–4 with special focus on stage 0, and furthermore to assess the influence of symptoms of chronic bronchitis on mortality risks in GOLD stages 1–4.

Method

Between 1974 and 1992, a total of 22 044 middle-aged individuals participated in a health screening, which included a spirometry as well as recording of respiratory symptoms and smoking habits. Individuals with comorbidity at baseline (diabetes, stroke, cancer, angina pectoris, or heart infarction) were excluded from the analyses. Hazard ratios (HR 95% CI) of total mortality were analyzed in GOLD stages 0–4 with individuals with normal lung function and without symptoms of chronic bronchitis as a reference group. HR:s in smoking individuals with symptoms of chronic bronchitis within the stages 1–4 were calculated with individuals with the same GOLD stage but without symptoms of chronic bronchitis as reference.

Results

The number of deaths was 3674 for men and 832 for women based on 352 324 and 150 050 person-years respectively. The proportion of smokers among men was 50% and among women 40%. Self reported comorbidity was present in 4.6% of the men and 6.6% of the women. Among smoking men, Stage 0 was associated with an increased mortality risk, HR; 1.65 (1.32–2.08), of similar magnitude as in stage 2, HR; 1.41 (1.31–1.70). The hazard ratio in stage 0 was significantly higher than in stage 1 HR; 1.13 (0.98–1.29). Among male smokers with stage 1; HR: 2.04 (1.34–3.11), and among female smokers with stage 2 disease; HR: 3.16 (1.38–7.23), increased HR:s were found in individuals with symptoms of chronic bronchitis as compared to those without symptoms of chronic bronchitis.

Conclusion

Symptoms fulfilling the definition of chronic bronchitis were associated with an increased mortality risk among male smokers with normal pulmonary function (stage 0) and also with an increased risk of death among smoking individuals with mild to moderate COPD (stage 1 and 2).

【 授权许可】

   
2005 Ekberg-Aronsson et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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