Advanced

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

Ekberg, Marie LU ; Pehrsson, Kerstin LU ; Nilsson, Jan-Åke; Nilsson, Peter and Löfdahl, Claes-Göran LU (2005) In Respiratory Research 6(1).
Abstract
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... (More)
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). (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
chronic bronchitis, COPD, epidemiology, FEV1, GOLD, mortality, respiratory symptoms, smoking
in
Respiratory Research
volume
6
issue
1
publisher
BioMed Central
external identifiers
  • wos:000232032000001
  • pmid:16120227
  • scopus:26244444367
ISSN
1465-9921
DOI
10.1186/1465-9921-6-98
language
English
LU publication?
yes
id
e61663f9-8a4a-48ba-80b8-dbaaf4a75735 (old id 909152)
date added to LUP
2008-01-11 15:02:50
date last changed
2017-03-12 03:22:58
@article{e61663f9-8a4a-48ba-80b8-dbaaf4a75735,
  abstract     = {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).},
  articleno    = {98},
  author       = {Ekberg, Marie and Pehrsson, Kerstin and Nilsson, Jan-Åke and Nilsson, Peter and Löfdahl, Claes-Göran},
  issn         = {1465-9921},
  keyword      = {chronic bronchitis,COPD,epidemiology,FEV1,GOLD,mortality,respiratory symptoms,smoking},
  language     = {eng},
  number       = {1},
  publisher    = {BioMed Central},
  series       = {Respiratory Research},
  title        = {Mortality in GOLD stages of COPD and its dependence on symptoms of chronic bronchitis},
  url          = {http://dx.doi.org/10.1186/1465-9921-6-98},
  volume       = {6},
  year         = {2005},
}