All-cause and cause-specific mortality from restrictive and obstructive spirometric patterns in Chinese adults with and without dyspnea: Guangzhou Biobank Cohort Study. (May 2019)

• Record Type: Journal Article
• Authors: Pan, Jing; Adab, Peymane; Jiang, Chao Qiang; Zhang, Wei Sen; Zhu, Feng; Jin, Ya Li; Thomas, G. Neil; Lam, Tai Hing
• Is Part Of: Respiratory medicine. Volume 151(2019)
• Page Start: 66
• Page End: 80
• Publication Date: 2019-05
• Subjects: Restriction on spirometry -- Airflow obstruction -- Dyspnea -- Mortality; Chest -- Diseases -- Periodicals; Chest -- Diseases -- Great Britain -- Periodicals; Respiratory organs -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Appareil respiratoire -- Maladies -- Périodiques; Thorax -- Maladies -- Périodiques; Appareil respiratoire -- Maladies -- Traitement -- Périodiques; Electronic journals; 616.2
• DOI: 10.1016/j.rmed.2019.04.002
• Languages: English
• ISSNs: 0954-6111

Abstract

Abstract: Objective: To study whether abnormal spirometric patterns were associated with differential mortality in Chinese adults with and without dyspnea. Methods: Guangzhou Biobank Cohort Study (GBCS) participants were classified by spirometric patterns and presence of dyspnea into 6 groups: normal spirometry (NS), restriction on spirometry (ROS) and airflow obstruction (AO), each with and without dyspnea. Adjusted hazard ratios (aHRs) were calculated for mortality using Cox models. Results: Among 16777 subjects, 1595 (9.5%) had ROS, 1036 (6.2%) had AO and 1009 (6.0%) had dyspnea. A total of 1993 deaths (11.9%) occurred during 11-year follow-up. Using NS without dyspnea as reference, NS with dyspnea was significantly associated with increased cardiovascular mortality risk (aHRs 1.61 (95% confidence interval (CI) 1.18–2.19); ROS with and without dyspnea were associated with increased risks of all-cause (aHRs 1.46 (95% CI 1.28–1.66) and 1.81 (95% CI 1.33–2.47)) and cardiovascular mortality (aHRs 1.89 (95% CI 1.55–2.31) and 1.85 (95% CI 1.12–3.03)), but not of lung cancer mortality (aHRs 1.33 (95% CI 0.91–1.94) and 1.35 (95% CI 0.49–3.70)); AO with and without dyspnea were associated with increased risks of all-cause (aHRs 1.59 (95% CI 1.36–1.86) and 2.36 (95% CI 1.77–3.15)), cardiovascular (aHRs 1.43 (95% CI 1.08–1.90) and 1.61 (95% CI 0.91–2.82)) and lung cancer mortality (aHRs 1.91 (95% CI 1.29–2.84) and 3.01 (95% CI 1.46–6.23)). These associations did not vary by sex or smoking status (all P-values for interaction >0.05). Conclusion: Both ROS and AO, with and without dyspnea, were associated with increased all-cause and cardiovascular disease mortality. The increased risk of all-cause was greater and that of cardiovascular mortality was lower for AO than ROS. AO showed significantly increased risk of lung cancer but ROS did not. (272 words). Highlights: Both ROS and AO, w/& w/o dyspnea, had increased all-cause and cardiovascular disease mortality. The increased risk of all-cause mortality was greater for AO than ROS. The increased risk of cardiovascular mortality was lower for AO than ROS. AO showed significantly increased risk of lung cancer but ROS did not. The mortality risk associated with dyspnea varied by spirometric patterns.