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Mortality and its predictive factors in participants with asthma : a 26-year follow-up

Kisiel, Marta A. ; Zhou, Xingwu ; Fundberg, Ida ; Barrling, Amelie ; Lindelöf, Herman Sundqvist ; Hiller, Adriana Maria LU orcid ; Janson, Christer and Rask-Andersen, Anna (2025) In Respiratory Medicine 246.
Abstract

Background: The long-term impact of asthma on mortality remains uncertain. This study aimed to assess mortality and its predictors over 26 years in asthmatic participants compared to those with or without other respiratory symptoms. Methods: This longitudinal cohort study included participants recruited from the general Swedish population, followed from 1990 to 2016. The younger (30–39 years, n = 938) and older (60–69 years, at baseline, n = 1020) groups were divided into asthma, other and no respiratory symptoms. Baseline data included spirometry, allergy testing, smoking status, and quality of life. Survival analyses were conducted using Kaplan-Meier and Cox proportional hazards models. Results: At 26-years follow-up the survival... (More)

Background: The long-term impact of asthma on mortality remains uncertain. This study aimed to assess mortality and its predictors over 26 years in asthmatic participants compared to those with or without other respiratory symptoms. Methods: This longitudinal cohort study included participants recruited from the general Swedish population, followed from 1990 to 2016. The younger (30–39 years, n = 938) and older (60–69 years, at baseline, n = 1020) groups were divided into asthma, other and no respiratory symptoms. Baseline data included spirometry, allergy testing, smoking status, and quality of life. Survival analyses were conducted using Kaplan-Meier and Cox proportional hazards models. Results: At 26-years follow-up the survival rates were 34 % and 95 % for asthmatics in the older and younger age groups, respectively. Asthma was not found to be a statistically significant independent predictor of mortality when compared to non-asthmatics in either age group (older group HR 95 % CI: 0.94 (0.77–1.15); younger group: 1.39 (0.63–3.09). Significant mortality predictors included increasing age ((1.13 (1.10–1.16)), male sex (1.73 (1.44–2.07), smoking (2.01 (1.65–2.44), lower forced expiratory volume in 1 s (FEV1) (0.67 (0.60–0.76), and more symptoms (1.21 (1.01–1.45) in the older group, while age (1.14 (1.02–1.27) and other respiratory symptoms (2.44 (1.18–5.03) were predictors in the younger group. Risk factors significantly linked to mortality among older asthmatics included older age, male sex and current passive smoking, and only male sex in younger asthmatics. Conclusion: Asthma was not a strong independent predictor of mortality in either age group, whereas age, male sex, other respiratory symptoms, smoking, and lower FEV1, but not quality of life, were key risk factors. These findings highlight the importance of identifying high-risk individuals and addressing modifiable lifestyle factors such as smoking in mortality prevention strategies.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
All-cause mortality, Asthma, Lung function, Other respiratory symptoms, Quality of life
in
Respiratory Medicine
volume
246
article number
108253
publisher
Elsevier
external identifiers
  • scopus:105010433240
  • pmid:40651560
ISSN
0954-6111
DOI
10.1016/j.rmed.2025.108253
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2025
id
a2c871f7-6e7d-4da8-b0bd-9cd1d3d0665a
date added to LUP
2025-11-27 13:43:28
date last changed
2025-11-28 03:23:35
@article{a2c871f7-6e7d-4da8-b0bd-9cd1d3d0665a,
  abstract     = {{<p>Background: The long-term impact of asthma on mortality remains uncertain. This study aimed to assess mortality and its predictors over 26 years in asthmatic participants compared to those with or without other respiratory symptoms. Methods: This longitudinal cohort study included participants recruited from the general Swedish population, followed from 1990 to 2016. The younger (30–39 years, n = 938) and older (60–69 years, at baseline, n = 1020) groups were divided into asthma, other and no respiratory symptoms. Baseline data included spirometry, allergy testing, smoking status, and quality of life. Survival analyses were conducted using Kaplan-Meier and Cox proportional hazards models. Results: At 26-years follow-up the survival rates were 34 % and 95 % for asthmatics in the older and younger age groups, respectively. Asthma was not found to be a statistically significant independent predictor of mortality when compared to non-asthmatics in either age group (older group HR 95 % CI: 0.94 (0.77–1.15); younger group: 1.39 (0.63–3.09). Significant mortality predictors included increasing age ((1.13 (1.10–1.16)), male sex (1.73 (1.44–2.07), smoking (2.01 (1.65–2.44), lower forced expiratory volume in 1 s (FEV<sub>1</sub>) (0.67 (0.60–0.76), and more symptoms (1.21 (1.01–1.45) in the older group, while age (1.14 (1.02–1.27) and other respiratory symptoms (2.44 (1.18–5.03) were predictors in the younger group. Risk factors significantly linked to mortality among older asthmatics included older age, male sex and current passive smoking, and only male sex in younger asthmatics. Conclusion: Asthma was not a strong independent predictor of mortality in either age group, whereas age, male sex, other respiratory symptoms, smoking, and lower FEV<sub>1</sub>, but not quality of life, were key risk factors. These findings highlight the importance of identifying high-risk individuals and addressing modifiable lifestyle factors such as smoking in mortality prevention strategies.</p>}},
  author       = {{Kisiel, Marta A. and Zhou, Xingwu and Fundberg, Ida and Barrling, Amelie and Lindelöf, Herman Sundqvist and Hiller, Adriana Maria and Janson, Christer and Rask-Andersen, Anna}},
  issn         = {{0954-6111}},
  keywords     = {{All-cause mortality; Asthma; Lung function; Other respiratory symptoms; Quality of life}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Respiratory Medicine}},
  title        = {{Mortality and its predictive factors in participants with asthma : a 26-year follow-up}},
  url          = {{http://dx.doi.org/10.1016/j.rmed.2025.108253}},
  doi          = {{10.1016/j.rmed.2025.108253}},
  volume       = {{246}},
  year         = {{2025}},
}