Prevalence, Medicaid use and mortality risk of low FEV1 in adults aged 20–35 years old in the USA: evidence from a population-based retrospective cohort study

IF 3.6 3区医学 Q1 RESPIRATORY SYSTEM

BMJ Open Respiratory Research Pub Date : 2024-05-01 DOI:10.1136/bmjresp-2023-001918

Zihui Wang, Yun Li, Lunfang Tan, Shuyi Liu, Zhufeng Wang, Qing Zhang, Junfeng Lin, Jinhai Huang, Lina Liang, Yi Gao, Nanshan Zhong, Jinping Zheng

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Abstract

Background The prevalence, Medicaid use and mortality risk associated with low forced expiratory volume in 1 s (FEV1) among young adults aged 20–35 years are not well understood, despite its potential implications for the development of chronic pulmonary disease and overall prognosis. Methods A retrospective cohort study was conducted among young adults aged 20–35 years old, using data from the National Health and Nutrition Examination Survey, National Death Index and Centers for Medicare & Medicaid Services. Participants were categorised into a low FEV1 group (pre-bronchodilator FEV1%pred <80%) and a normal FEV1 group (FEV1%pred ≥80%). Weighted logistic regression analysis was employed to identify the risk factors associated with low FEV1, while Cox proportional hazard models were used to calculate the hazard ratio (HR) for Medicaid use and the all-cause mortality between the two groups. Results A total of 5346 participants aged 20–35 were included in the study, with 329 in the low FEV1 group and 5017 in the normal group. The weighted prevalence of low FEV1 among young adults was 7.1% (95% CI 6.0 to 8.2). Low body mass index (OR=3.06, 95% CI 1.79 to 5.24), doctor-diagnosed asthma (OR=2.25, 1.28 to 3.93), and wheezing or whistling (OR=1.57, 1.06 to 2.33) were identified as independent risk factors for low FEV1. Over a 15-year follow-up, individuals in the low FEV1 group exhibited a higher likelihood of Medicaid use compared with those in the normal group (HR=1.73, 1.07 to 2.79). However, there was no statistically significant increase in the risk of all-cause mortality over a 30-year follow-up period (HR=1.48, 1.00 to 2.19). Conclusions A considerable portion of young adults demonstrated low FEV1 levels, a characteristic that was associated with a higher risk of Medicaid use over a long-term follow-up, yet not linked to an augmented risk of all-cause mortality. Data sharing is not applicable because no new dataset was generated and the data used in this study were originally from publicly available databases.

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美国 20-35 岁成年人中低 FEV1 的流行率、医疗补助的使用情况和死亡风险：一项基于人群的回顾性队列研究提供的证据

背景尽管低 1 秒用力呼气容积（FEV1）对慢性肺部疾病的发展和整体预后有潜在影响，但人们对 20-35 岁青壮年中低 1 秒用力呼气容积（FEV1）的患病率、医疗补助的使用和相关的死亡风险还不甚了解。方法利用全国健康与营养调查、全国死亡指数和美国医疗保险与医疗补助服务中心的数据，对 20-35 岁的年轻人进行了一项回顾性队列研究。参与者被分为低 FEV1 组（支气管扩张剂前 FEV1%pred <80%）和正常 FEV1 组（FEV1%pred ≥80%）。采用加权逻辑回归分析确定与低 FEV1 相关的风险因素，同时采用 Cox 比例危险模型计算两组之间使用医疗补助的危险比（HR）和全因死亡率。结果共有 5346 名 20-35 岁的参与者参与了研究，其中低 FEV1 组有 329 人，正常组有 5017 人。低 FEV1 在年轻人中的加权患病率为 7.1%（95% CI 6.0 至 8.2）。低体重指数（OR=3.06，95% CI 1.79 至 5.24）、医生诊断的哮喘（OR=2.25，1.28 至 3.93）以及喘息或啸叫（OR=1.57，1.06 至 2.33）被确定为低 FEV1 的独立风险因素。在 15 年的随访中，低 FEV1 组与正常组相比，使用医疗补助的可能性更高（HR=1.73，1.07 至 2.79）。然而，在 30 年的随访期间，全因死亡的风险并没有统计学意义上的显著增加（HR=1.48，1.00 至 2.19）。结论相当一部分年轻人的 FEV1 水平较低，这一特征与长期随访中使用医疗补助的风险较高有关，但与全因死亡风险增加无关。数据共享不适用，因为没有生成新的数据集，本研究中使用的数据最初来自公开数据库。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMJ Open Respiratory Research RESPIRATORY SYSTEM-

CiteScore

6.60

自引率

2.40%

发文量

审稿时长

12 weeks

期刊介绍： BMJ Open Respiratory Research is a peer-reviewed, open access journal publishing respiratory and critical care medicine. It is the sister journal to Thorax and co-owned by the British Thoracic Society and BMJ. The journal focuses on robustness of methodology and scientific rigour with less emphasis on novelty or perceived impact. BMJ Open Respiratory Research operates a rapid review process, with continuous publication online, ensuring timely, up-to-date research is available worldwide. The journal publishes review articles and all research study types: Basic science including laboratory based experiments and animal models, Pilot studies or proof of concept, Observational studies, Study protocols, Registries, Clinical trials from phase I to multicentre randomised clinical trials, Systematic reviews and meta-analyses.