Tiina Mattila1, Tuula Vasankari2, Merja Kanervisto3, Tarja Laitinen4, Olli Impivaara5, Harri Rissanen6, Paul Knekt7, Pekka Jousilahti8, Seppo Saarelainen9, Pauli Puukka10, Markku Heliövaara11. 1. Department of Lung Diseases, Helsinki University Hospital, Meilahti Triangle Hospital, 6th Floor, PO Box 372, 00029 HUS, Finland. Electronic address: tiina.m.mattila@fimnet.fi. 2. Finnish Lung Health Association (FILHA), Filha ry, Sibeliuksenkatu 11 A 1, 00250 Helsinki, Finland. Electronic address: tuula.vasankari@filha.fi. 3. School of Health Sciences, University of Tampere, Niittytie 1, 33470 Ylöjärvi, Finland. Electronic address: Merja.Kanervisto@uta.fi. 4. Division of Medicine, Department of Pulmonary Diseases and Clinical Allergology, Turku University Hospital and University of Turku, PO Box 52 (Hämeentie 11), 20521 Turku, Finland. Electronic address: tarja.helena.laitinen@tyks.fi. 5. National Institute for Health and Welfare, PO Box 30, 00271 Helsinki, Finland. Electronic address: olli.impivaara@thl.fi. 6. National Institute for Health and Welfare, PO Box 30, 00271 Helsinki, Finland. Electronic address: harri.rissanen@thl.fi. 7. National Institute for Health and Welfare, PO Box 30, 00271 Helsinki, Finland. Electronic address: paul.knekt@thl.fi. 8. National Institute for Health and Welfare, PO Box 30, 00271 Helsinki, Finland. Electronic address: pekka.jousilahti@thl.fi. 9. Department of Respiratory Medicine, Tampere University Hospital, 33521 Tampere, Finland. Electronic address: seppo.saarelainen@pshp.fi. 10. National Institute for Health and Welfare, PO Box 30, 00271 Helsinki, Finland. Electronic address: pauli.puukka@thl.fi. 11. National Institute for Health and Welfare, PO Box 30, 00271 Helsinki, Finland. Electronic address: markku.heliovaara@thl.fi.
Abstract
BACKGROUND: Mortality correlates with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria of airway obstruction. Yet, little data exist concerning the long-term survival of patients presenting with different levels of obstruction. METHODS: We studied the association between all-cause and cause-specific mortality and GOLD stages 1-4 in a 30-year follow-up among 6636 Finnish men and women aged 30 or older participating in the Mini-Finland Health Study between 1978 and 1980. RESULTS: After adjusting for age, sex, and smoking history, the GOLD stage of the subject showed a strong direct relationship with all-cause mortality, mortality from cardiovascular and respiratory diseases, and cancer. The adjusted hazard ratios of death were 1.27 (95% confidence interval (CI) 1.06-1.51), 1.40 (1.21-1.63), 1.55 (1.21-1.97) and 2.85 (1.65-4.94) for GOLD stages 1-4, respectively, with FEV1/FVC ≥70% as the reference. The association between GOLD stages 2-4 and mortality was strongest among subjects under 50 years of age at the baseline measurement. Cardiovascular mortality increased consistently for all GOLD stages. CONCLUSIONS: Airway obstruction indicates an increased risk for all-cause mortality according to the severity of the GOLD stage. We found that even stage 1 carries a risk for cardiovascular death independently of smoking history and other known risk factors.
BACKGROUND: Mortality correlates with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria of airway obstruction. Yet, little data exist concerning the long-term survival of patients presenting with different levels of obstruction. METHODS: We studied the association between all-cause and cause-specific mortality and GOLD stages 1-4 in a 30-year follow-up among 6636 Finnish men and women aged 30 or older participating in the Mini-Finland Health Study between 1978 and 1980. RESULTS: After adjusting for age, sex, and smoking history, the GOLD stage of the subject showed a strong direct relationship with all-cause mortality, mortality from cardiovascular and respiratory diseases, and cancer. The adjusted hazard ratios of death were 1.27 (95% confidence interval (CI) 1.06-1.51), 1.40 (1.21-1.63), 1.55 (1.21-1.97) and 2.85 (1.65-4.94) for GOLD stages 1-4, respectively, with FEV1/FVC ≥70% as the reference. The association between GOLD stages 2-4 and mortality was strongest among subjects under 50 years of age at the baseline measurement. Cardiovascular mortality increased consistently for all GOLD stages. CONCLUSIONS:Airway obstruction indicates an increased risk for all-cause mortality according to the severity of the GOLD stage. We found that even stage 1 carries a risk for cardiovascular death independently of smoking history and other known risk factors.
Authors: Tiina Mattila; Tuula Vasankari; Harri Rissanen; Paul Knekt; Pauli Puukka; Markku Heliövaara Journal: Eur J Epidemiol Date: 2017-07-07 Impact factor: 8.082
Authors: Stephen G Spiro; Pallav L Shah; Robert C Rintoul; Jeremy George; Samuel Janes; Matthew Callister; Marco Novelli; Penny Shaw; Gabrijela Kocjan; Chris Griffiths; Mary Falzon; Richard Booton; Nicholas Magee; Michael Peake; Paul Dhillon; Kishore Sridharan; Andrew G Nicholson; Simon Padley; Magali N Taylor; Asia Ahmed; Jack Allen; Yenting Ngai; Nyasha Chinyanganya; Victoria Ashford-Turner; Sarah Lewis; Dahmane Oukrif; Pamela Rabbitts; Nicholas Counsell; Allan Hackshaw Journal: Eur Respir J Date: 2019-10-17 Impact factor: 16.671
Authors: Irmeli Lindström; Paula Pallasaho; Jouko Remes; Tuula Vasankari; Markku Heliövaara Journal: BMC Public Health Date: 2020-02-03 Impact factor: 3.295