Causes of and Clinical Features Associated with Death in Tobacco Cigarette Users by Lung Function Impairment
Rationale: Cigarette smoking contributes to the risk of death through different mechanisms. Objectives: To determine how causes of and clinical features associated with death vary in tobacco cigarette users by lung function impairment. Methods: We stratified current and former tobacco cigarette users enrolled in Genetic Epidemiology of Chronic Obstructive Pulmonary Disease (COPDGene) into normal spirometry, PRISm (Preserved Ratio Impaired Spirometry), Global Initiative for Chronic Obstructive Lung Disease (GOLD) 1-2 COPD, and GOLD 3-4 COPD. Deaths were identified via longitudinal follow-up and Social Security Death Index search. Causes of death were adjudicated after a review of death certificates, medical records, and next-of-kin interviews. We tested associations between baseline clinical variables and all-cause mortality using multivariable Cox proportional hazards models. Measurements and Main Results: Over a 10.1-year median follow-up, 2,200 deaths occurred among 10,132 participants (age 59.5 ± 9.0 yr; 46.6% women). Death from cardiovascular disease was most frequent in PRISm (31% of deaths). Lung cancer deaths were most frequent in GOLD 1-2 (18% of deaths vs. 9-11% in other groups). Respiratory deaths outpaced competing causes of death in GOLD 3-4, particularly when BODE index ⩾7. St. George's Respiratory Questionnaire score ⩾25 was associated with higher mortality in all groups: Hazard ratio (HR), 1.48 (1.20-1.84) normal spirometry; HR, 1.40 (1.05-1.87) PRISm; HR, 1.80 (1.49-2.17) GOLD 1-2; HR, 1.65 (1.26-2.17) GOLD 3-4. History of respiratory exacerbations was associated with higher mortality in GOLD 1-2 and GOLD 3-4, quantitative emphysema in GOLD 1-2, and airway wall thickness in PRISm and GOLD 3-4. Conclusions: Leading causes of death vary by lung function impairment in tobacco cigarette users. Worse respiratory-related quality of life is associated with all-cause mortality regardless of lung function.
| Errataetall: |
CommentIn: Am J Respir Crit Care Med. 2023 Aug 15;208(4):354-356. - PMID 37429287 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:208 |
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| Enthalten in: |
American journal of respiratory and critical care medicine - 208(2023), 4 vom: 15. Aug., Seite 451-460 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Labaki, Wassim W [VerfasserIn] |
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| Links: |
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| Themen: |
Exacerbations |
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| Anmerkungen: |
Date Completed 16.08.2023 Date Revised 28.03.2024 published: Print CommentIn: Am J Respir Crit Care Med. 2023 Aug 15;208(4):354-356. - PMID 37429287 Citation Status MEDLINE |
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| doi: |
10.1164/rccm.202210-1887OC |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 245 | 1 | 0 | |a Causes of and Clinical Features Associated with Death in Tobacco Cigarette Users by Lung Function Impairment |
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| 500 | |a CommentIn: Am J Respir Crit Care Med. 2023 Aug 15;208(4):354-356. - PMID 37429287 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Rationale: Cigarette smoking contributes to the risk of death through different mechanisms. Objectives: To determine how causes of and clinical features associated with death vary in tobacco cigarette users by lung function impairment. Methods: We stratified current and former tobacco cigarette users enrolled in Genetic Epidemiology of Chronic Obstructive Pulmonary Disease (COPDGene) into normal spirometry, PRISm (Preserved Ratio Impaired Spirometry), Global Initiative for Chronic Obstructive Lung Disease (GOLD) 1-2 COPD, and GOLD 3-4 COPD. Deaths were identified via longitudinal follow-up and Social Security Death Index search. Causes of death were adjudicated after a review of death certificates, medical records, and next-of-kin interviews. We tested associations between baseline clinical variables and all-cause mortality using multivariable Cox proportional hazards models. Measurements and Main Results: Over a 10.1-year median follow-up, 2,200 deaths occurred among 10,132 participants (age 59.5 ± 9.0 yr; 46.6% women). Death from cardiovascular disease was most frequent in PRISm (31% of deaths). Lung cancer deaths were most frequent in GOLD 1-2 (18% of deaths vs. 9-11% in other groups). Respiratory deaths outpaced competing causes of death in GOLD 3-4, particularly when BODE index ⩾7. St. George's Respiratory Questionnaire score ⩾25 was associated with higher mortality in all groups: Hazard ratio (HR), 1.48 (1.20-1.84) normal spirometry; HR, 1.40 (1.05-1.87) PRISm; HR, 1.80 (1.49-2.17) GOLD 1-2; HR, 1.65 (1.26-2.17) GOLD 3-4. History of respiratory exacerbations was associated with higher mortality in GOLD 1-2 and GOLD 3-4, quantitative emphysema in GOLD 1-2, and airway wall thickness in PRISm and GOLD 3-4. Conclusions: Leading causes of death vary by lung function impairment in tobacco cigarette users. Worse respiratory-related quality of life is associated with all-cause mortality regardless of lung function | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a exacerbations | |
| 650 | 4 | |a mortality | |
| 650 | 4 | |a respiratory-related quality of life | |
| 650 | 4 | |a smokers | |
| 650 | 4 | |a spirometry | |
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| 700 | 1 | |a Curtis, Jeffrey L |e verfasserin |4 aut | |
| 700 | 1 | |a Wells, J Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Bhatt, Surya P |e verfasserin |4 aut | |
| 700 | 1 | |a Bon, Jessica |e verfasserin |4 aut | |
| 700 | 1 | |a Diaz, Alejandro A |e verfasserin |4 aut | |
| 700 | 1 | |a Hersh, Craig P |e verfasserin |4 aut | |
| 700 | 1 | |a Wan, Emily S |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Victor |e verfasserin |4 aut | |
| 700 | 1 | |a Beaty, Terri H |e verfasserin |4 aut | |
| 700 | 1 | |a Hokanson, John E |e verfasserin |4 aut | |
| 700 | 1 | |a Bowler, Russell P |e verfasserin |4 aut | |
| 700 | 1 | |a Arenberg, Douglas A |e verfasserin |4 aut | |
| 700 | 1 | |a Kazerooni, Ella A |e verfasserin |4 aut | |
| 700 | 1 | |a Martinez, Fernando J |e verfasserin |4 aut | |
| 700 | 1 | |a Silverman, Edwin K |e verfasserin |4 aut | |
| 700 | 1 | |a Crapo, James D |e verfasserin |4 aut | |
| 700 | 1 | |a Make, Barry J |e verfasserin |4 aut | |
| 700 | 1 | |a Regan, Elizabeth A |e verfasserin |4 aut | |
| 700 | 1 | |a Han, MeiLan K |e verfasserin |4 aut | |
| 700 | 0 | |a COPDGene Investigators – Core Units |e verfasserin |4 aut | |
| 700 | 0 | |a COPDGene Investigators – Clinical Centers |e verfasserin |4 aut | |
| 700 | 1 | |a Crapo, James D |e investigator |4 oth | |
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| 700 | 1 | |a Make, Barry J |e investigator |4 oth | |
| 700 | 1 | |a Regan, Elizabeth A |e investigator |4 oth | |
| 700 | 1 | |a Beaty, Terri H |e investigator |4 oth | |
| 700 | 1 | |a Castaldi, Peter J |e investigator |4 oth | |
| 700 | 1 | |a Cho, Michael H |e investigator |4 oth | |
| 700 | 1 | |a DeMeo, Dawn L |e investigator |4 oth | |
| 700 | 1 | |a Boueiz, Adel El |e investigator |4 oth | |
| 700 | 1 | |a Foreman, Marilyn G |e investigator |4 oth | |
| 700 | 1 | |a Ghosh, Auyon |e investigator |4 oth | |
| 700 | 1 | |a Hayden, Lystra P |e investigator |4 oth | |
| 700 | 1 | |a Hersh, Craig P |e investigator |4 oth | |
| 700 | 1 | |a Hetmanski, Jacqueline |e investigator |4 oth | |
| 700 | 1 | |a Hobbs, Brian D |e investigator |4 oth | |
| 700 | 1 | |a Hokanson, John E |e investigator |4 oth | |
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| 700 | 1 | |a Sakornsakolpat, Phuwanat |e investigator |4 oth | |
| 700 | 1 | |a Silverman, Edwin K |e investigator |4 oth | |
| 700 | 1 | |a Wan, Emily S |e investigator |4 oth | |
| 700 | 1 | |a Yun, Jeong |e investigator |4 oth | |
| 700 | 1 | |a Centeno, Juan Pablo |e investigator |4 oth | |
| 700 | 1 | |a Charbonnier, Jean-Paul |e investigator |4 oth | |
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| 700 | 1 | |a Austin, Erin |e investigator |4 oth | |
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| 700 | 1 | |a Lutz, Sharon M |e investigator |4 oth | |
| 700 | 1 | |a Young, Kendra A |e investigator |4 oth | |
| 700 | 1 | |a Bhatt, Surya P |e investigator |4 oth | |
| 700 | 1 | |a Bon, Jessica |e investigator |4 oth | |
| 700 | 1 | |a Diaz, Alejandro A |e investigator |4 oth | |
| 700 | 1 | |a Han, MeiLan K |e investigator |4 oth | |
| 700 | 1 | |a Make, Barry |e investigator |4 oth | |
| 700 | 1 | |a Murray, Susan |e investigator |4 oth | |
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