Association of Preserved-Ratio Impaired Spirometry (PRISm) with All-Cause Mortality: A Longitudinal Cohort Study.

Yunjoo Im, Taeyun Kim, Jung Hye Hwang, Hyunsoo Kim, Seokmin Hyun, So Rae Kim, Sun Hye Shin, Juhee Cho, Danbee Kang, Hye Yun Park
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Abstract

Rationale: Numerous studies indicate that preserved-ratio impaired spirometry (PRISm) is associated with adverse clinical outcomes. However, the impact of PRISm severity, particularly in regard to forced vital capacity (FVC), on mortality risk remains unclear. Objectives: To determine whether PRISm was associated with mortality and to identify specific groups with particularly increased mortality rates. Methods: This retrospective study enrolled individuals aged >40 years who underwent comprehensive health screening at the Center for Health Promotion at Samsung Medical Center between 2003 and 2020. PRISm was characterized by a ratio of forced expiratory volume in 1 second to FVC of at least 0.7 and forced expiratory volume in 1 second <80% of predicted values. Participants were classified into three groups: normal lung function, PRISm with normal FVC, and PRISm with low FVC (FVC <80% predicted). We compared all-cause mortality rates using the Kaplan-Meier method and the Cox proportional hazard ratio model. Results: Among 106,458 individuals, 86,208 exhibited normal lung function, 6,249 had PRISm with normal FVC, and 14,001 had PRISm with low FVC. Over a median follow-up of 10.1 years, 2,219 participants died. Individuals with PRISm experienced a higher cumulative mortality rate compared with those with normal lung function (39 vs. 16 per 10,000 person-years; adjusted hazard ratio, 1.43; 95% confidence interval [CI], 1.31-1.56). The fully adjusted hazard ratios for all-cause mortality in PRISm with normal and low FVC were 1.25 (95% CI, 1.03-1.52) and 1.47 (95% CI, 1.33-1.62) relative to those with normal lung function, respectively. Conclusions: PRISm is associated with an increased risk of death, particularly when accompanied by low FVC.

肺活量保留率受损(PRISm)与全因死亡率的关系:纵向队列研究
理由:大量研究表明,肺活量保留比值受损(PRISm)与不良临床结果有关。然而,PRISm 严重程度(尤其是 FVC)对死亡风险的影响仍不清楚:确定 PRISm 是否与死亡率相关,并确定死亡率特别高的特定人群:这项回顾性研究招募了 2003 年至 2020 年期间在三星医疗中心健康促进中心接受全面健康检查的 40 岁以上的人。PRISm 的特征是 FEV1/FVC ≥ 0.7 和 FEV1 结果:在 106,458 人中,86,208 人肺功能正常,6,249 人 PRISm 且 FVC 正常,14,001 人 PRISm 且 FVC 低。在 10.1 年的中位随访中,有 2,219 人死亡。与肺功能正常者相比,PRISm 患者的累积死亡率更高(每 10,000 人年 39 例与 16 例;调整后 HR 1.43,95% CI 1.31-1.56)。与肺功能正常者相比,FVC正常和FVC较低的PRISm患者全因死亡率的完全调整HR分别为1.25(95% CI 1.03-1.52)和1.47(95% CI 1.33-1.62):PRISm与死亡风险的增加有关,尤其是伴有低FVC时。
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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