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Respiratory Medicine

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Association between all-cause and cause-specific mortality and the GOLD stages 1–4: A 30-year follow-up among Finnish adults - 30/07/15

Doi : 10.1016/j.rmed.2015.06.002 
Tiina Mattila a, ⁎ , Tuula Vasankari b , Merja Kanervisto c , Tarja Laitinen d , Olli Impivaara e , Harri Rissanen e , Paul Knekt e , Pekka Jousilahti e , Seppo Saarelainen f , Pauli Puukka e , Markku Heliövaara e
a Department of Lung Diseases, Helsinki University Hospital, Meilahti Triangle Hospital, 6th Floor, PO Box 372, 00029 HUS, Finland 
b Finnish Lung Health Association (FILHA), Filha ry, Sibeliuksenkatu 11 A 1, 00250 Helsinki, Finland 
c School of Health Sciences, University of Tampere, Niittytie 1, 33470 Ylöjärvi, Finland 
d 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 
e National Institute for Health and Welfare, PO Box 30, 00271 Helsinki, Finland 
f Department of Respiratory Medicine, Tampere University Hospital, 33521 Tampere, Finland 

∗Corresponding author. Permanent address (on maternity leave, until February 2016): Kuusmiehenpolku 10H, 00670 Helsinki, Finland.

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.

Le texte complet de cet article est disponible en PDF.

Highlights

•
GOLD stage is directly proportional to mortality.
•
Already GOLD stage 1 predicts cardiovascular mortality.
•
All-cause mortality is clearly increased in GOLD stages 2–4 <50 years of age.

Le texte complet de cet article est disponible en PDF.

Keywords : COPD, Mortality, Respiratory epidemiology, Epidemiological study


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© 2015  Elsevier Ltd. Tous droits réservés.
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Vol 109 - N° 8

P. 1012-1018 - août 2015 Retour au numéro
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