All-cause and cause-specific mortality by spirometric pattern and sex - a population-based cohort study

Area of Science:

• Pulmonary Medicine
• Epidemiology
• Cardiovascular Health

Background:

• Chronic airway obstruction (CAO) and restrictive spirometry pattern (RSP) are known mortality risk factors.
• However, sex-specific differences in all-cause and cause-specific mortality for these conditions remain under-evaluated.

Purpose of the Study:

• To investigate sex-dependent variations in all-cause and cause-specific mortality among individuals with CAO and RSP.
• To compare these patterns against those observed in individuals with normal lung function (NLF).

Main Methods:

• A population-based prospective cohort study was conducted using data from the Obstructive Lung Disease in Northern Sweden (OLIN) studies (2002-2004).
• Mortality data were collected through April 2016, encompassing approximately 19,000 patient-years.
• Cox and Fine-Gray regression models were employed to estimate adjusted hazard ratios, controlling for age, BMI, sex, and smoking status.

Main Results:

• Both CAO and RSP were associated with higher adjusted hazards for all-cause mortality compared to NLF, with these elevated risks primarily driven by males.
• CAO showed increased hazards for respiratory and cardiovascular death. Respiratory death risk was significant in women, while cardiovascular death risk was significant in men.
• RSP was associated with an increased hazard for respiratory death in both sexes, but not cardiovascular death.

Conclusions:

• The heightened risk of all-cause mortality in CAO and RSP is predominantly observed in males.
• CAO is linked to distinct cause-specific mortality patterns: respiratory death in women and cardiovascular death in men.
• RSP is associated with an increased risk of respiratory death, affecting both sexes similarly.