Laxmi Bhatta1, Linda Leivseth2, David Carslake3,4, Arnulf Langhammer5, Xiao-Mei Mai1, Yue Chen6, Anne H Henriksen7,8, Ben M Brumpton3,8,9. 1. Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU Norwegian University of Science and Technology, Trondheim, Norway. 2. Centre for Clinical Documentation and Evaluation (SKDE), Northern Norway Regional Health Authority, Tromsø, Norway. 3. MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK. 4. Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK. 5. HUNT Research Centre, NTNU Norwegian University of Science and Technology, Levanger, Norway. 6. School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada. 7. Department of Circulation and Medical Imaging, NTNU Norwegian University of Science and Technology, Trondheim, Norway. 8. Clinic of Thoracic and Occupational Medicine, St. Olavs Hospital, Trondheim, Norway. 9. K.G. Jebsen Center for Genetic Epidemiology, NTNU Norwegian University of Science and Technology, Trondheim, Norway.
Abstract
BACKGROUND AND OBJECTIVE: Post-bronchodilator (BD) lung function is recommended for the diagnosis of chronic obstructive pulmonary disease (COPD). However, often only pre-BD lung function is used in clinical practice or epidemiological studies. We aimed to compare the discrimination ability of pre-BD and post-BD lung function to predict all-cause mortality. METHODS: Participants aged ≥40 years with airflow limitation (n = 2538) and COPD (n = 1262) in the second survey of the Nord-Trøndelag Health Study (HUNT2, 1995-1997) were followed up until 31 December 2015. Survival analysis and time-dependent area under the receiver operating characteristic curves (AUC) were used to compare the discrimination ability of pre-BD and post-BD lung function (percent-predicted forced expiratory volume in the first second (FEV1 ) (ppFEV1 ), FEV1 z-score, FEV1 quotient (FEV1 Q), modified Global Initiative for Chronic Obstructive Lung Disease (GOLD) categories or GOLD grades). RESULTS: Among 2538 participants, 1387 died. The AUC for pre-BD and post-BD ppFEV1 to predict mortality were 60.8 and 61.8 (P = 0.005), respectively, at 20 years' follow-up. The corresponding AUC for FEV1 z-score were 58.5 and 60.4 (P < 0.001), for FEV1 Q were 68.7 and 70.1 (P = 0.002) and for modified GOLD categories were 62.3 and 64.5 (P < 0.001). Among participants with COPD, the AUC for pre-BD and post-BD ppFEV1 were 57.0 and 58.8 (P < 0.001), respectively. The corresponding AUC for FEV1 z-score were 53.1 and 55.8 (P < 0.001), for FEV1 Q were 63.6 and 65.1 (P = 0.037) and for GOLD grades were 56.0 and 57.0 (P = 0.268). CONCLUSION: Mortality was better predicted by post-BD than by pre-BD lung function; however, they differed only by a small margin. The discrimination ability using GOLD grades among COPD participants was similar.
BACKGROUND AND OBJECTIVE: Post-bronchodilator (BD) lung function is recommended for the diagnosis of chronic obstructive pulmonary disease (COPD). However, often only pre-BD lung function is used in clinical practice or epidemiological studies. We aimed to compare the discrimination ability of pre-BD and post-BD lung function to predict all-cause mortality. METHODS:Participants aged ≥40 years with airflow limitation (n = 2538) and COPD (n = 1262) in the second survey of the Nord-Trøndelag Health Study (HUNT2, 1995-1997) were followed up until 31 December 2015. Survival analysis and time-dependent area under the receiver operating characteristic curves (AUC) were used to compare the discrimination ability of pre-BD and post-BD lung function (percent-predicted forced expiratory volume in the first second (FEV1 ) (ppFEV1 ), FEV1 z-score, FEV1 quotient (FEV1 Q), modified Global Initiative for Chronic Obstructive Lung Disease (GOLD) categories or GOLD grades). RESULTS: Among 2538 participants, 1387 died. The AUC for pre-BD and post-BD ppFEV1 to predict mortality were 60.8 and 61.8 (P = 0.005), respectively, at 20 years' follow-up. The corresponding AUC for FEV1 z-score were 58.5 and 60.4 (P < 0.001), for FEV1 Q were 68.7 and 70.1 (P = 0.002) and for modified GOLD categories were 62.3 and 64.5 (P < 0.001). Among participants with COPD, the AUC for pre-BD and post-BD ppFEV1 were 57.0 and 58.8 (P < 0.001), respectively. The corresponding AUC for FEV1 z-score were 53.1 and 55.8 (P < 0.001), for FEV1 Q were 63.6 and 65.1 (P = 0.037) and for GOLD grades were 56.0 and 57.0 (P = 0.268). CONCLUSION: Mortality was better predicted by post-BD than by pre-BD lung function; however, they differed only by a small margin. The discrimination ability using GOLD grades among COPDparticipants was similar.
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Authors: Terezia Pincikova; Tiphaine Parrot; Lena Hjelte; Marieann Högman; Karin Lisspers; Björn Ställberg; Christer Janson; Andrei Malinovschi; Johan K Sandberg Journal: Respir Res Date: 2022-05-18
Authors: Jennifer L Perret; Don Vicendese; Koen Simons; Debbie L Jarvis; Adrian J Lowe; Caroline J Lodge; Dinh S Bui; Daniel Tan; John A Burgess; Bircan Erbas; Adrian Bickerstaffe; Kerry Hancock; Bruce R Thompson; Garun S Hamilton; Robert Adams; Geza P Benke; Paul S Thomas; Peter Frith; Christine F McDonald; Tony Blakely; Michael J Abramson; E Haydn Walters; Cosetta Minelli; Shyamali C Dharmage Journal: BMJ Open Respir Res Date: 2021-12