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Prevalence, Characteristics, and Prognosis of Early Chronic Obstructive Pulmonary Disease. The Copenhagen General
Yunus Çolak1,2,3, Shoaib Afzal1,2,3, Børge G Nordestgaard1,2,3
1Department of Clinical Biochemistry.
Insights
Fifteen percent of adults under 50 with significant smoking history have early chronic obstructive pulmonary disease (COPD). Early COPD is linked to respiratory symptoms, lung impairment, and increased hospitalization and mortality risks.
Area of Science:
- Pulmonary Medicine
- Epidemiology
- Preventive Health
Background:
- Early identification of chronic obstructive pulmonary disease (COPD) in younger adults is crucial for implementing preventive strategies.
- Understanding the prevalence and characteristics of early COPD can inform targeted interventions before significant disease progression.
Purpose of the Study:
- To determine the prevalence, identify characteristics, and assess the prognosis of early chronic obstructive pulmonary disease (COPD) in the general adult population.
- To investigate the association between early COPD and respiratory symptoms, lung function, and long-term health outcomes.
Main Methods:
- A Danish population-based cohort study included 105,630 adults.
- Early COPD was defined in individuals under 50 years with $\geq$10 pack-years of smoking and airflow limitation (FEV1/FVC < LLN).
- Follow-up over 14.4 years assessed hospitalizations and mortality.
Main Results:
- Among 8,064 eligible younger adults, 15% (1,175) were diagnosed with early COPD.
- Individuals with early COPD exhibited more chronic respiratory symptoms, severe lung function impairment, asthma, and a history of bronchitis/pneumonia.
- Early COPD was associated with significantly increased risks of obstructive lung disease hospitalizations (HR 6.42), pneumonia hospitalizations (HR 2.03), and all-cause mortality (HR 1.79).
Conclusions:
- 15% of adults under 50 with a substantial smoking history meet criteria for early COPD.
- Early COPD is characterized by respiratory symptoms and impaired lung function, indicating a higher risk of adverse respiratory events and premature death.
- These findings highlight the importance of early detection and intervention for COPD in younger, at-risk populations.
Abstract:
Rationale: Identification of younger adults at high risk of developing chronic obstructive pulmonary disease (COPD) could lead to implementation of preventive measures before disease onset and halt progression.Objectives: To investigate the prevalence, characteristics, and prognosis of individuals with early COPD in the general population.Methods: We investigated 105,630 randomly chosen adults from a Danish contemporary population-based cohort. Early COPD was defined as FEV1/FVC less than the lower limit of normal in individuals under 50 years of age with 10 pack-years or greater of tobacco consumption.Measurements and Main Results: Among 8,064 individuals under 50 years of age with 10 pack-years or greater of tobacco consumption, 1,175 (15%) had early COPD, of whom 58% were current smokers. Individuals with early COPD more often had chronic respiratory symptoms, severe lung function impairment, asthma, and a history with bronchitis/pneumonia. During the 14.4-year follow-up, we observed 117 acute hospitalizations with obstructive lung disease, 227 acute hospitalizations with pneumonia, and 185 deaths among the 8,064 younger adults. Compared with individuals without COPD, those with early COPD had multivariable adjusted hazard ratios of 6.42 (95% confidence interval, 3.39-12.2) for acute obstructive lung disease hospitalizations, 2.03 (1.43-2.88) for acute pneumonia hospitalizations, and 1.79 (1.28-2.52) for all-cause mortality.Conclusions: Among individuals under 50 years of age and 10 pack-years or greater of tobacco consumption from the general population, 15% fulfill criteria of early COPD. Individuals with early COPD more often have chronic respiratory symptoms and severe lung function impairment, and an increased risk of acute respiratory hospitalizations and early death.
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