Annals of the American Thoracic Society最新文献

{"title":"Sedation Practices during Continuous Neuromuscular Blockade for Acute Respiratory Distress Syndrome.","authors":"Peter J Dunbar, Ryan A Peterson, Max McGrath, Tyree H Kiser, P Michael Ho, R William Vandivier, Ellen L Burnham, Marc Moss, Peter D Sottile","doi":"10.1513/AnnalsATS.202411-1225OC","DOIUrl":"10.1513/AnnalsATS.202411-1225OC","url":null,"abstract":"<p><p><b>Rationale:</b> Neuromuscular blockade (NMB) is frequently used during acute respiratory distress syndrome (ARDS) to improve ventilator synchrony. Which sedating medications are used concomitantly during NMB and whether sedation choice influences patient outcomes are unclear. <b>Objectives:</b> To determine national sedation practice patterns during NMB in patients with and at risk for ARDS and to establish whether the use of propofol and opioids compared with benzodiazepines and opioids is associated with improved outcomes. <b>Methods:</b> Using a U.S. national database from 2010 to 2021, intubated and mechanically ventilated patients receiving NMB for a diagnosis of ARDS or an ARDS risk factor over at least two hospital days after admission were included. Charges for sedation and analgesia during the first two hospital days were recorded for each patient. The relationships between propofol and opioids and between benzodiazepines and opioids, with a primary outcome of ventilator-free days, as well as secondary outcomes of 28-day survival and discharge home were examined in multivariable analyses. <b>Results:</b> We determined that the use of propofol has increased compared with that of benzodiazepines as the primary sedative used during NMB for ARDS. Compared with benzodiazepine and opioid use, propofol and opioid use during NMB for ARDS was associated with increased ventilator-free days (adjusted odds ratio, 1.38 [95% confidence interval, 1.24-1.54]), greater odds for survival at 28 days (adjusted odds ratio, 1.15 [95% confidence interval, 1.01-1.31]), and greater odds for discharge home (adjusted odds ratio, 1.26 [95% confidence interval, 1.09-1.46]), adjusting for patient-level and hospital-level characteristics. <b>Conclusions:</b> From 2010 to 2021, sedation practice during NMB for ARDS shifted from predominately benzodiazepine use to predominately propofol use. The use of propofol and opioids is associated with an increase in ventilator-free days compared with the use of benzodiazepines and opioids. These results suggest that sedation choice during NMB for ARDS may affect clinical outcomes; further investigation is needed to validate these findings.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"1394-1400"},"PeriodicalIF":5.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fine Particulate Matter and Mortality in Chronic Obstructive Pulmonary Disease with Multimorbidity.","authors":"Camille E Robichaux, Arianne K Baldomero, Amy A Gravely, Chris H Wendt, Jesse D Berman","doi":"10.1513/AnnalsATS.202411-1200OC","DOIUrl":"10.1513/AnnalsATS.202411-1200OC","url":null,"abstract":"<p><p><b>Rationale:</b> Exposure to particulate matter with an aerodynamic diameter ≤2.5 μm (PM_2.5) is associated with respiratory dysfunction and increased risk of death. The U.S. Environmental Protection Agency has established regulatory standards for long-term exposure in the general population, but the risk for individuals with existing respiratory disease is unclear. <b>Objectives:</b> Estimate the association between long-term PM_2.5 exposure and mortality in individuals with chronic obstructive pulmonary disease (COPD), including the modifying effects of comorbidities at low levels of exposure. <b>Methods:</b> We performed a retrospective cohort analysis of all patients with a COPD diagnosis in the Veterans Health Administration between 2016 and 2019. Annual ambient concentrations of PM_2.5 were obtained from publicly available pollutant models and spatially assigned to patient households. Primary outcomes were adjusted odds of mortality per 1-μg/m³ increase in 5-year PM_2.5 concentrations and identification of comorbidities associated with increased susceptibility. <b>Results:</b> Medical records from 1,124,973 veterans with COPD were analyzed. Most of the cohort were male (95.60%), and the cohort had diverse racial, socioeconomic, and geographic characteristics. The odds of death was 3.8% higher for every 1-μg/m³ increase in long-term PM_2.5 (adjusted odds ratio [aOR], 1.038; 95% confidence interval [CI], 1.035-1.040). For people with comorbid lung cancer (aOR, 1.051; 95% CI, 1.035-1.068), coronary arterial disease (aOR, 1.039; 95% CI, 1.033, 1.044), or chronic kidney disease (aOR, 1.042; 95% CI, 1.034, 1.049), the risk of death was significantly higher than for those without. <b>Conclusions:</b> The risk of mortality increases at even small magnitudes of increased PM_2.5 concentrations in people with COPD. The risk was higher for those with comorbid lung cancer, coronary artery disease, and chronic kidney disease. The current standard of 9 μg/m³ for the general population should be reevaluated for those with existing COPD.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"1335-1342"},"PeriodicalIF":5.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Working Together in Sarcoidosis: Experience and Impact of a Formalized Multidisciplinary Discussion.","authors":"Michelle Sharp, Ali M Mustafa, Kristen Mathias, Jasmine Malhi, Edward S Chen, Stephen C Mathai, Barney J Stern, Susana C Dominguez-Penuela, Paula Barreras, Nisha A Gilotra","doi":"10.1513/AnnalsATS.202412-1294RL","DOIUrl":"10.1513/AnnalsATS.202412-1294RL","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":"1436-1439"},"PeriodicalIF":5.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a Model of Health and Supportive Care for People with Silicosis in Australia.","authors":"Gabriella Tikellis, Tamera Corte, Ryan Hoy, Hayley Barnes, Jessica Rhodes, Fiona Hore-Lacy, Anne E Holland","doi":"10.1513/AnnalsATS.202503-363OC","DOIUrl":"https://doi.org/10.1513/AnnalsATS.202503-363OC","url":null,"abstract":"<p><strong>Rationale: </strong>Silicosis is an occupational lung disease caused by the inhalation of respirable crystalline silica (RCS) dust. Stone benchtop industry workers exposed to RCS are at high risk of artificial stone silicosis, a totally preventable disease with no cure and limited treatment options. Little is known about the impact and daily challenges associated with living with the disease.</p><p><strong>Objective: </strong>This study aimed to develop a model of health and supportive care addressing the needs of people with silicosis based on their lived experiences.</p><p><strong>Methods: </strong>Patients with silicosis identified from two Australian tertiary clinics were invited to participate in semi-structured interviews by telephone from May to August 2024. Interviews explored the impact of silicosis on health, wellbeing, and supportive care needs. Interviews were transcribed verbatim and thematic analysis was used to identify key elements of a health and supportive care model.</p><p><strong>Results: </strong>40 people were interviewed. All were male with an average age of 42.80±9.24 years (range 29-62 years). Major themes included: unclear pathway to diagnosis; uncertainty regarding prognosis; limited information on silicosis especially in other languages; significant financial impact related to loss of occupation, with substantial effects on mental health; and challenges of managing life with silicosis. Components of the person-centred, individualised care model included: lung health, mental health, reliable information, occupational support, fitness programs, lifestyle, peer support, care pathways and coordination.</p><p><strong>Conclusion: </strong>People with silicosis have a range of unmet health care and supportive needs. The proposed model provides a person-centred approach to meet the unique needs of this cohort.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144877233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Outcomes of Persistent Critical Illness.","authors":"Louisa W J He, Ary Serpa Neto, Alisa M Higgins, Carol L Hodgson","doi":"10.1513/AnnalsATS.202410-1044OC","DOIUrl":"https://doi.org/10.1513/AnnalsATS.202410-1044OC","url":null,"abstract":"<p><strong>Rationale: </strong>Persistent critical illness (PerCI) describes a growing group of intensive care unit (ICU) patients whose critical illness persist into chronicity. They account for a disproportionate amount of resources, yet long-term functional outcomes are unknown.</p><p><strong>Objectives: </strong>To compare death or new disability at six months in ICU patients with and without PerCI (defined as ≥10 days ICU stay).</p><p><strong>Methods: </strong>Secondary analysis of a multi-centre, prospective cohort study conducted in six metropolitan ICUs. Participants were adults admitted to ICU who received >24 hours mechanical ventilation. Patients who died before day 10 were excluded from the control group. The primary outcome was death or new disability at six months, adjusted for various covariates, with new disability defined as ≥10% increase in WHODAS 2.0. Various secondary outcomes (including quality of life, cognition, mental health, return to work) were included to assess recovery holistically at three and six months. A significance level of 0.01 was used to compensate for multiplicity.</p><p><strong>Results: </strong>Of 888 total enrolled patients, 799 survived to day 10. Of these, the primary outcome was available in 670 (84%) patients, 188 with PerCI and 482 in the control. The primary outcome was present in 124/171 (72.5%) of patients with PerCI and 236/457 (53.9%) of the control124/171 (72.5%) and 236/457 (53.9%) respectively (adjusted risk difference 10.70 [95% CI 0.47-20.90]; p=0.040).]). At six months, the mortality rate was higher in the PerCI group compared to control: respectively 76/252 (30.2%) and 57/547 (10.4%) (adjusted risk difference 15.04 [95% CI 9.65-20.39]; p<0.001).]). In survivors, 48/95 (50.5%) of the PerCI group developed a new disability, compared to 100/311 (32.2%) in the control (adjusted risk difference 9.98 [95% CI -0.27-20.20]; p=0.056).]). Assessment of secondary outcomes showed several differences at three months which were reduced by six months, and residual differences were largely related to physical function.</p><p><strong>Conclusion: </strong>Patients with PerCI had a higher similar incidence of death or new disability at six months. However, assessment of secondary outcomes showed significant recovery in PerCI survivors between three and six months.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-center Study of Hyperpolarized Xenon MRI in Children with Cystic Fibrosis Following Initiation of CFTR Modulator Therapy (HyPOINT).","authors":"Felix A Ratjen, Sanja Stanojevic, Samal Munidasa, David Roach, Jaime Mata, Deborah K Froh, Brandon Zanette, Giles Santyr, Sean B Fain, Michael J Rock, Laura L Walkup, Jason C Woods","doi":"10.1513/AnnalsATS.202501-028OC","DOIUrl":"https://doi.org/10.1513/AnnalsATS.202501-028OC","url":null,"abstract":"<p><strong>Rationale: </strong>Elexacaftor/tezacaftor/ivacaftor (ETI) has significantly improved lung function in people with cystic fibrosis (CF), prompting the need for outcome measures that can detect mild disease. In this new era of CFTR modulator therapy, more sensitive endpoints are required to evaluate the progression of early lung disease and to determine the efficacy of new CF therapies. Prior to the availability of highly effective therapies 129Xenon magnetic resonance imaging (Xe MRI) was shown to be more sensitive to regional ventilation changes compared to spirometry.</p><p><strong>Objectives: </strong>To evaluate the longitudinal changes in pulmonary function and Xe-MRI outcomes after treatment with ETI in children and young people with CF.</p><p><strong>Methods: </strong>Lung function was assessed longitudinally at baseline 1, 6, and 12 months following ETI treatment initiation in children and young people with CF between the ages of 6 and 18 years at four study sites. Ventilation defect percentage (VDP), reader-defect percentage (RDP), Lung Clearance Index (LCI) and Forced Expiratory Volume in 1 second (FEV1) were reported.</p><p><strong>Measurements and main results: </strong>A total of 28 participants were enrolled; 25 completed at least baseline and one-month measurements. All four measures (RDP, VDP, LCI and FEV1) improved at one month after ETI initiation with a mean (standard deviation) absolute change of -1.2 (1.7) in LCI, 6.9 (12.3) in FEV1, -4.3 (4.8) in VDP and --7.8 (9.6) in RDP, respectively. Xe MRI outcomes (RDP and VDP) showed the largest relative treatment effects with mean relative improvements of 43% and 72%, respectively. One third of participants (8/25) had improvements in VDP and RDP but did not show improvements in FEV1.</p><p><strong>Conclusions: </strong>Xe MRI captures sustained ventilation improvements following ETI initiation. Xe MRI metrics may provide a suitable endpoint for future interventional trials-particularly for people with CF with mild lung disease.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cough in Adults with Undiagnosed Respiratory Symptoms.","authors":"Sheojung Shin, Jessica Poliwoda, G A Whitmore, Katherine L Vandemheen, Celine Bergeron, Louis-Philippe Boulet, Andréanne Côté, Stephen K Field, Erika Penz, R Andrew McIvor, Catherine Lemière, Samir Gupta, Paul Hernandez, Irvin Mayers, Mohit Bhutani, M Diane Lougheed, Christopher J Licskai, Tanweer Azher, Nicole Ezer, Martha Ainslie, Tetyana Kendzerska, Gonzalo G Alvarez, Sunita Mulpuru, Shawn D Aaron","doi":"10.1513/AnnalsATS.202412-1329OC","DOIUrl":"https://doi.org/10.1513/AnnalsATS.202412-1329OC","url":null,"abstract":"<p><strong>Rationale: </strong>Cough is a common symptom of undiagnosed respiratory conditions.</p><p><strong>Objective: </strong>To investigate cough in adults with undiagnosed respiratory symptoms and its association with quality of life (QoL), sleep quality, and healthcare utilization for respiratory illness.</p><p><strong>Methods: </strong>We used a case-finding strategy to find community-dwelling adults with respiratory symptoms but no previous history of diagnosed lung disease. Pre- and post-bronchodilator spirometry determined if participants met diagnostic criteria for asthma, chronic obstructive pulmonary disease (COPD), preserved ratio impaired spirometry (PRISm), or if they had normal spirometry. Twelve questions from the Asthma Screening Questionnaire, COPD Assessment Test, and the St. George's Respiratory Questionnaire were used to develop a cough score. The 36-Item Short Form Survey (SF-36) and Global Sleep Assessment Questionnaire (GSAQ) were used to assess QoL and sleep quality, respectively.</p><p><strong>Results: </strong>Adults with undiagnosed respiratory symptoms (N=2857, mean score 57.8, 95%CI 56.9-58.6) reported higher cough scores than age-matched controls (N=231, mean score 17.7, 95%CI 15.6-19.8). Participants found to have asthma (N=265, mean score 61.0, 95%CI 58.2-63.7) and COPD (N=330, mean score 61.8, 95%CI 59.3 to 64.3) had higher cough scores than those with PRISm (N=172, mean score 54.5, 95%CI 51.1-58.0) or normal spirometry (N=2090, mean score 57.0, 95%CI 56.0-58.0). Higher cough scores were associated with decreased QoL (lower SF-36 score, regression coefficient -0.19; 95%CI -0.22 to -0.17, P <0.001), worse sleep quality (higher GSAQ score, regression coefficient 0.16, 95%CI 0.14-0.18, P <0.001), and higher healthcare utilization for respiratory illness (incidence rate ratio 1.007, 95%CI 1.004-1.010, P <0.001).</p><p><strong>Conclusions: </strong>In adults with undiagnosed respiratory symptoms, cough was most severe in those with undiagnosed asthma or COPD and was independently associated with worse quality of life, impaired sleep quality, and higher healthcare utilization for respiratory illness.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of Alpha-1 Antitrypsin Deficiency in the Veterans Health Administration.","authors":"Leonard Riley, Robert Fredenrich, Matthew Bearce, Sushant Govindan, Spencer Schafer, Michael Campos, Jorge Lascano","doi":"10.1513/AnnalsATS.202503-325OC","DOIUrl":"https://doi.org/10.1513/AnnalsATS.202503-325OC","url":null,"abstract":"<p><strong>Rationale: </strong>Alpha-1 antitrypsin (AAT) deficiency (AATD) is a known but underrecognized genetic cause of chronic obstructive pulmonary disease (COPD) and liver disease. Little is known about the epidemiology and burden of AATD among U.S. Veterans.</p><p><strong>Objectives: </strong>To examine the Veteran characteristics and epidemiology of AATD and severe AATD throughout the Veterans Health Administration (VHA).</p><p><strong>Methods: </strong>Data was obtained from the electronic health record to describe demographic, clinical, testing outcomes, and geographic data for Veterans between January 1, 2010 through December 31, 2019. Multivariable logistic regression analysis was performed to evaluate Veteran characteristics associated with AATD. We defined intermediate AATD as a serum AAT level >57 and <100 mg/dL or any allelic combination other than PI*MM, PI*MS, PI*SZ, or PI*ZZ. Severe AATD was defined by either PI*ZZ and PI*SZ genotypes as well as any combination with a serum level ≤57 mg/dL (≤11 µmol/L).</p><p><strong>Results: </strong>Among 12 million Veterans enrolled during the study period, 175,508 were tested for AATD, and 8,832 were diagnosed with intermediate AATD and 3,088 were diagnosed with severe AATD. The positivity rate of AATD varied year-to-year ranging from 62 - 76 cases per 1,000 persons tested. AATD occurred in 57 cases per 1,000 persons tested with COPD, and there were 66 cases of AATD per 1,000 persons tested with liver disease; however, testing rates of COPD (4.04%) or liver disease (17.91%) were low. There was a heterogenous distribution of AATD throughout the United States. Factors associated with detection and diagnosis of AATD included younger age, White race, and no history of tobacco use.</p><p><strong>Conclusions: </strong>This study represents a national analysis of AATD in the Veterans Health Administration. Although the annual positivity rates of AATD among those tested varied over the decade, it confirmed AATD is prevalent in Veterans. However, the number of eligible Veterans tested is low, which highlights the need for increased awareness of this condition.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Elexacaftor/Tezacaftor/Ivacaftor on Cardiopulmonary Exercise Testing in Adults with Cystic Fibrosis-A Retrospective Study.","authors":"Roger Auth, Louise Collins, Joshua Tanzer, Brian Casserly, Charlotte Hanly, Caitriona McGarth, Melrose Livera, Derbhla O'Sullivan, Michael Blundin, Eric Gartman","doi":"10.1513/AnnalsATS.202501-007RL","DOIUrl":"https://doi.org/10.1513/AnnalsATS.202501-007RL","url":null,"abstract":"","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Profile of Young Adults with Chronic Obstructive Pulmonary Disease.","authors":"Andrea S Gershon, Joseph Munn, Rachel E McGihon, Priscila Pequeno, Jin Luo, Alina Blazer, Tetyana Kendzerska, Shawn D Aaron, Teresa To","doi":"10.1513/AnnalsATS.202502-185OC","DOIUrl":"https://doi.org/10.1513/AnnalsATS.202502-185OC","url":null,"abstract":"<p><strong>Background: </strong>COPD risk profiles have been described in populations comprised of or including older adults, leaving factors associated with COPD in younger adults overlooked. We aimed to determine patient profiles of physician diagnosed COPD in younger adults.</p><p><strong>Methods: </strong>A cohort study was conducted using population-based survey data linked to health administrative data from Ontario, Canada from 2007 to 2018. Younger adults 35 to 55 years newly diagnosed with COPD by physicians were matched to controls without physician diagnosed COPD. Multivariable conditional logistic regression models were used to identify statistically significant predictors of COPD. To contextualize results, the analysis was repeated in older adults.</p><p><strong>Findings: </strong>There were 1094 younger adults with new physician diagnosed COPD. In adjusted analysis, previous influenza or pneumonia, higher level of comorbidity, a mental health condition and a history of asthma independently predicted COPD diagnosis in younger adults. With the exception of mental health conditions, these same variables predicted COPD diagnosis in older adults. However, male sex, lower income, a history of respiratory disease other than asthma, and being overweight or underweight predicted COPD diagnosis in older but not in younger adults.</p><p><strong>Interpretation: </strong>Having a mental health condition was associated with physician diagnosed COPD in younger adults while male sex, lower income, a history of respiratory disease other than asthma, and being overweight or underweight did not. This new knowledge can be used to dispel stereotypes about COPD. They also suggest that different screening criteria should be considered for younger adults.</p>","PeriodicalId":93876,"journal":{"name":"Annals of the American Thoracic Society","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}