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Publications

Journal Article Ppublish

PubMed: 42251731 DOI: 10.1093/ije/dyag093

A cohort study of forced vital capacity, airway obstruction, and survival in the multinational Burden of Obstructive Lung Disease study.

Int J Epidemiol 55(3)

Authors: Peter G J Burney, Emmanouil Bagkeris, James Potts, Rune Nielsen, Graham Devereux, Karima El Rhazi, Althea Aquart-Stewart, Asaad A Nafees, Parvaiz Koul, Padukudru Anand Mahesh, Dhiraj Agarwal, Sanjay Juvekar, Thorarinn Gislason, Meriam Denguezli, Imed Harrabi, Stefanni Nonna M Paraguas, Rain Jogi, Gregory Erhabor, A Sonia Buist, Christer Janson, Andre F S Amaral

Affiliations

  • National Heart and Lung Institute, Imperial College London, London, United Kingdom.
  • Department of Clinical Science, University of Bergen, Bergen, Norway.
  • Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway.
  • Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
  • Department of Epidemiology and Public Health, Faculty of Medicine, Dentistry and Pharmacy, Sidi Mohamed Ben Abdillah University, Hassan II University Hospital Center of Fez, Fez, Morocco.
  • Department of Medicine, University of the West Indies, Mona Campus, Kingston, Jamaica.
  • Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
  • Department of Pulmonary Medicine, Sheri Kashmir Institute of Medical Sciences, Srinagar, India.
  • Department of Respiratory Medicine, JSS Medical College, Mysuru, Karnataka, India.
  • Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India.
  • Dr D.Y. Patil Medical College, Hospital and Research Centre, Dr D.Y. Patil Vidyapeeth, Pimpri, Pune, India.
  • Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
  • Department of Sleep, Landspitali University Hospital, Reykjavik, Iceland.
  • Faculté de Médecine Dentaire de Monastir, Université de Monastir, Monastir, Tunisia.
  • Ibn El Jazzar Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia.
  • Philippine College of Chest Physicians, Quezon City, Philippines.
  • Philippine Heart Centre, Quezon City, Philippines.
  • Lung Clinic, Tartu University Hospital, Tartu, Estonia.
  • Department of Medicine, Obafemi Awolowo University/Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State, Nigeria.
  • School of Medicine, Oregon Health and Science University, Portland, OR, United States.
  • Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden.
  • NIHR Imperial Biomedical Research Centre, London, United Kingdom.

Abstract

BACKGROUND

In the USA, higher forced vital capacity (FVC) is linked with longer survival, and FVC is associated with survival independently of ethnicity. The implications for the low FVC values in parts of Asia and Africa are unknown.

METHODS

We used data from 16 sites of the multinational Burden of Obstructive Lung Disease (BOLD) study that completed follow-up of participants between 2019 and 2021 and reported at least five deaths between baseline and follow-up. We assessed the association of mortality with FVC and Forced Expiratory Volume in 1 second (FEV1)/FVC ratio within each site using Cox proportional hazards models. These models were adjusted for age, smoking, height, and weight. Effect estimates from all sites were combined using meta-analysis. Systematic regional differences were investigated.

RESULTS

Of 9927 study participants with follow-up data, 1120 (11.3%) had died [mean follow-up = 8.7 years, standard deviation (SD) = 3.3 years]. Baseline post-bronchodilator FVC and FEV1/FVC were inversely associated with mortality. When both FVC and FEV1/FVC were mutually adjusted for each other, the decreased mortality rates were more pronounced for each SD higher FVC at baseline [44% (95% confidence interval (CI): 25%, 58%) for men and 28% (95% CI: 11%, 41%) for women] than for FEV1/FVC at baseline [14% (95% CI: 8%, 20%) for men and 7% (95% CI: -10%, 21%) for women]. The probability of true regional differences was low.

CONCLUSIONS

People with a higher FVC adjusted for age, sex, and height have a longer survival. Regional adjustments to lung function standards are inappropriate when assessing prognosis.

MeSH

Mortality, Epidemiology, Lung, Airway Obstruction, Cohort Studies, Survival Analysis, Lung Diseases, Vital Capacity, Lung Diseases, Obstructive