Lung function decline and outcomes in an adult population

Am J Respir Crit Care Med. 2006 May 1;173(9):985-90. doi: 10.1164/rccm.200508-1344OC. Epub 2006 Jan 26.


Rationale: Chronic obstructive pulmonary disease (COPD) is an important cause of morbidity and mortality.

Objectives: To determine risk factors for and outcomes of rapid lung function decline in a cohort of adults in the United States.

Methods: We analyzed data from 15,536 adults aged 44-66 yr in the Atherosclerosis Risk in Communities study. We used Cox proportional hazard models to determine the risk of rapid lung function decline at 3 yr on mortality and COPD hospitalizations over the subsequent 8 yr.

Measurements and main results: Of those in the baseline cohort, 13,756 (88.5%) had spirometry at the Year 3 visit. The strongest risk factors for not having a follow-up spirometry were as follows: having Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage 3 or 4 disease at baseline (adjusted odds ratio [OR] 2.8; 95% confidence interval [CI], 2.1-3.8), being black (adjusted OR, 2.4; 95% CI, 2.1-2.7), and being a current smoker (adjusted OR, 1.8; 95% CI, 1.5-2.0). Participants with GOLD stage 3 or 4 disease were also more likely to be in the most rapidly declining lung function quartile (adjusted OR, 3.7; 95% CI, 2.7-5.0). Overall, participants with the most rapidly declining lung function had a modestly increased risk of death (adjusted hazard ratio, 1.4; 95% CI, 1.2-1.7) and time to a COPD-related hospitalization (adjusted hazard ratio, 1.4; 95% CI, 1.2-1.8).

Conclusion: Rapid lung function decline was independently associated with a modest increased risk of COPD hospitalizations and deaths.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Case-Control Studies
  • Cohort Studies
  • Female
  • Forced Expiratory Volume
  • Hospitalization
  • Humans
  • Logistic Models
  • Lung / physiopathology*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Pulmonary Disease, Chronic Obstructive / complications
  • Pulmonary Disease, Chronic Obstructive / mortality*
  • Pulmonary Disease, Chronic Obstructive / physiopathology*
  • Risk Factors
  • Spirometry
  • Survival Rate
  • United States
  • Vital Capacity